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Multifocal nodular periostitis associated with prolonged voriconazole therapy in a lung transplant recipient.

Abstract
We report a case of painful, nodular periostitis in a lung transplant recipient on long-term voriconazole therapy. Symptoms, signs, and laboratory abnormalities resolved quickly after drug withdrawal. The presentation more closely resembles periostitis deformans than hypertrophic osteoarthropathy, suggesting that the fluoride moiety of voriconazole may be pathogenic for this condition. Clinicians should be aware of this association.
AuthorsAsad Ayub, Charles V Kenney, Fergus E McKiernan
JournalJournal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases (J Clin Rheumatol) Vol. 17 Issue 2 Pg. 73-5 (Mar 2011) ISSN: 1536-7355 [Electronic] United States
PMID21169844 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antifungal Agents
  • Immunosuppressive Agents
  • Pyrimidines
  • Triazoles
  • Voriconazole
Topics
  • Aged
  • Antifungal Agents (adverse effects, therapeutic use)
  • Aspergillus fumigatus (isolation & purification)
  • Female
  • Graft Rejection (immunology, microbiology, prevention & control)
  • Humans
  • Immunosuppressive Agents (therapeutic use)
  • Lung Transplantation (immunology)
  • Opportunistic Infections (drug therapy, microbiology)
  • Periostitis (chemically induced, diagnostic imaging)
  • Pulmonary Aspergillosis (drug therapy)
  • Pulmonary Disease, Chronic Obstructive (surgery)
  • Pyrimidines (adverse effects, therapeutic use)
  • Radiography
  • Radionuclide Imaging
  • Triazoles (adverse effects, therapeutic use)
  • Voriconazole

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