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Pamidronate Results in Symptom Control of Hypertrophic Pulmonary Osteoarthropathy in Cystic Fibrosis*

Luke A. Garske, MBBS; Scott C. Bell, MD
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*From the Adult Cystic Fibrosis Unit and University of Queensland, The Prince Charles Hospital, Brisbane, Australia.

Correspondence to: Scott C. Bell, MD, Department of Thoracic Medicine, University of Queensland, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, Australia 4032; e-mail: scott_bell@health.qld.gov.au



Chest. 2002;121(4):1363-1364. doi:10.1378/chest.121.4.1363
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Hypertrophic pulmonary osteoarthropathy (HPOA) may complicate the advanced lung disease that is associated with cystic fibrosis, resulting in severe joint pain and early-morning stiffness. Symptoms are usually controlled with the administration of nonsteroidal anti-inflammatory drugs, physiotherapy, and, on occasions, oral corticosteroids. This report describes a case of refractory HPOA with complete remission following the administration of IV pamidronate, which is a potent inhibitor of osteoclastic bone resorption. Symptom relief resulted for up to 3 months, but repeated courses of pamidronate have been required to maintain symptom control.

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