Rachitic syndrome after disodium etidronate therapy in an adolescent

摘要: A 12-year-old patient with a severe traumatic brain injury developed heterotopic ossification (HO) rapidly decreasing range of motion in multiple joints despite intensive passive exercises and the use nonsteroidal antiinflammatory drugs (NSAIDs). His alkaline phosphatase was markedly elevated. Etidronate, 20mg/kg/d used to control ossification. After 7 months continual etidronate use, periarticular pain widened growth plates, suggesting rachitic syndrome. Serum laboratory panel including calcium, phosphorous, phosphatase, vitamin D were normal. 3 off etidronate, radiological studies showed plate calcification, though not before development bilateral slipped femoral capital epiphyses. Further improvement resolution all complications occurred 5 after discontinuation etidronate. Rachitic syndromes secondary didronel clinical setting has been previously reported. Other possible causes for present. Alternate treatments children or at risk HO should be considered.