Voriconazole-Associated Periostitis: New Insights into Pathophysiology and Management.

Autor: Bennett MJ; Department of Endocrinology and Diabetes St Vincent's Hospital Darlinghurst Australia.; St Vincent's Clinical School, UNSW Medicine Darlinghurst Australia., Balcerek MI; Department of Endocrinology and Diabetes Royal Brisbane and Women's Hospital Herston Australia., Lewis EA; Department of Rehabilitation Sacred Heart Health Service, St Vincent's Hospital Darlinghurst Australia., Zhang RL; Heart and Lung Transplant Unit St Vincent's Hospital Darlinghurst Australia., Bachmeier C; Chemical Pathology Pathology Queensland, Royal Brisbane and Women's Hospital Herston Australia., Tey S; Department of Haematology and Bone Marrow Transplantation Royal Brisbane and Women's Hospital Herston Australia., Faux S; Department of Rehabilitation Sacred Heart Health Service, St Vincent's Hospital Darlinghurst Australia., Girgis L; Department of Rheumatology St Vincent's Hospital Darlinghurst Australia., Greenfield JR; Department of Endocrinology and Diabetes St Vincent's Hospital Darlinghurst Australia., Lazarus S; Department of Endocrinology and Diabetes Royal Brisbane and Women's Hospital Herston Australia.; School of Clinical Medicine - Royal Brisbane Clinical Unit The University of Queensland Herston Australia.
Jazyk: angličtina
Zdroj: JBMR plus [JBMR Plus] 2021 Oct 06; Vol. 6 (2), pp. e10557. Date of Electronic Publication: 2021 Oct 06 (Print Publication: 2022).
DOI: 10.1002/jbm4.10557
Abstrakt: Voriconazole-associated periostitis (VAP) is an underrecognized and unpredictable side effect of long-term voriconazole therapy. We report two cases of VAP occurring in the post-transplant setting: a 68-year-old lung transplant recipient who required ongoing voriconazole therapy, in whom urinary alkalinization was used to promote fluoride excretion and minimize voriconazole-related skeletal toxicity, and a 68-year-old stem-cell transplant recipient with a high voriconazole dose requirement, identified on pharmacogenomic testing to be a CYP2C19 ultrarapid metabolizer, the dominant enzyme in voriconazole metabolism. This is the first reported case of pharmacogenomic profiling in VAP and may explain the variability in individual susceptibility to this uncommon adverse effect. Our findings provide new insights into both the management and underlying pathophysiology of VAP. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
(© 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.)
Databáze: MEDLINE
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