array:24 [ "pii" => "S2387020618302110" "issn" => "23870206" "doi" => "10.1016/j.medcle.2018.05.019" "estado" => "S300" "fechaPublicacion" => "2018-07-23" "aid" => "4297" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2017" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2018;151:81-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "PDF" => 2 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775317307881" "issn" => "00257753" "doi" => "10.1016/j.medcli.2017.10.010" "estado" => "S300" "fechaPublicacion" => "2018-07-23" "aid" => "4297" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2018;151:81-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 17 "formatos" => array:2 [ "HTML" => 11 "PDF" => 6 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científica</span>" "titulo" => "Osteonecrosis maxilar asociada a tratamiento con denosumab en una paciente con mastocitosis sistémica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "81" "paginaFinal" => "82" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Maxillar osteonecrosis associated to denosumab in a patient with systemic mastocytosis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 972 "Ancho" => 750 "Tamanyo" => 57448 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Área de osteonecrosis y osteólisis en maxilar izquierdo con secuestro óseo en su interior (la flecha representa la lesión).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Darío Sánchez López, Paolo Cariati, Miguel Pérez de Perceval Tara" "autores" => array:3 [ 0 => array:2 [ "nombre" => "José Darío" "apellidos" => "Sánchez López" ] 1 => array:2 [ "nombre" => "Paolo" "apellidos" => "Cariati" ] 2 => array:2 [ "nombre" => "Miguel" "apellidos" => "Pérez de Perceval Tara" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020618302110" "doi" => "10.1016/j.medcle.2018.05.019" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020618302110?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775317307881?idApp=UINPBA00004N" "url" => "/00257753/0000015100000002/v1_201807060854/S0025775317307881/v1_201807060854/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020618302134" "issn" => "23870206" "doi" => "10.1016/j.medcle.2018.05.021" "estado" => "S300" "fechaPublicacion" => "2018-07-23" "aid" => "4317" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2018;151:82-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Analysis of severe cases of epidemic influenza and its lethality in the last 5 flu seasons" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "82" "paginaFinal" => "83" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Análisis de los casos graves de gripe epidémica y su letalidad en las últimas 5 temporadas gripales" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jordi Reina, Carmen López de Bilbao, Melchor Riera" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Jordi" "apellidos" => "Reina" ] 1 => array:2 [ "nombre" => "Carmen" "apellidos" => "López de Bilbao" ] 2 => array:2 [ "nombre" => "Melchor" "apellidos" => "Riera" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775317308266" "doi" => "10.1016/j.medcli.2017.10.025" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775317308266?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020618302134?idApp=UINPBA00004N" "url" => "/23870206/0000015100000002/v1_201807220502/S2387020618302134/v1_201807220502/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020618302195" "issn" => "23870206" "doi" => "10.1016/j.medcle.2018.05.027" "estado" => "S300" "fechaPublicacion" => "2018-07-23" "aid" => "4397" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "pgl" "cita" => "Med Clin. 2018;151:80.e1-80.e10" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Consensus statement</span>" "titulo" => "Consensus document on the implementation of next generation sequencing in the genetic diagnosis of hereditary cancer" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "80.e1" "paginaFinal" => "80.e10" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Documento de consenso sobre la implementación de la secuenciación masiva de nueva generación en el diagnóstico genético de la predisposición hereditaria al cáncer" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Luis Soto, Ignacio Blanco, Orland Díez, Javier García Planells, Isabel Lorda, Gert Matthijs, Mercedes Robledo, Erika Souche, Conxi Lázaro" "autores" => array:9 [ 0 => array:2 [ "nombre" => "José Luis" "apellidos" => "Soto" ] 1 => array:2 [ "nombre" => "Ignacio" "apellidos" => "Blanco" ] 2 => array:2 [ "nombre" => "Orland" "apellidos" => "Díez" ] 3 => array:2 [ "nombre" => "Javier" "apellidos" => "García Planells" ] 4 => array:2 [ "nombre" => "Isabel" "apellidos" => "Lorda" ] 5 => array:2 [ "nombre" => "Gert" "apellidos" => "Matthijs" ] 6 => array:2 [ "nombre" => "Mercedes" "apellidos" => "Robledo" ] 7 => array:2 [ "nombre" => "Erika" "apellidos" => "Souche" ] 8 => array:2 [ "nombre" => "Conxi" "apellidos" => "Lázaro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775318300356" "doi" => "10.1016/j.medcli.2017.12.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775318300356?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020618302195?idApp=UINPBA00004N" "url" => "/23870206/0000015100000002/v1_201807220502/S2387020618302195/v1_201807220502/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Maxillar osteonecrosis associated to denosumab in a patient with systemic mastocytosis" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "81" "paginaFinal" => "82" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José Darío Sánchez López, Paolo Cariati, Miguel Pérez de Perceval Tara" "autores" => array:3 [ 0 => array:4 [ "nombre" => "José Darío" "apellidos" => "Sánchez López" "email" => array:1 [ 0 => "josed.sanchez.sspa@juntadeandalucia.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Paolo" "apellidos" => "Cariati" ] 2 => array:2 [ "nombre" => "Miguel" "apellidos" => "Pérez de Perceval Tara" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Cirugía Oral y Maxilofacial, Hospital Universitario Virgen de las Nieves, Granada, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Osteonecrosis maxilar asociada a tratamiento con denosumab en una paciente con mastocitosis sistémica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 972 "Ancho" => 750 "Tamanyo" => 36333 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Area of osteonecrosis and osteolysis in the left jaw with bone sequestrum (the arrow represents the lesion).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The systemic form of mastocytosis constitutes 10% of the total and can be classified into 4 different forms.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a 46-year-old female patient with a previous history of hysterectomy due to myomas, having frequent episodes of urticaria treated with antihistamines, as well as frequent gastrointestinal pain, diarrhoea and gastroesophageal reflux. Haematology confirmed the diagnosis of mastocytosis by bone marrow fine-needle biopsy and immunophenotypic study with the presence of 0.01% of mast cells (CD117++/+++/CD34−/CD45++/CD203c+), with a weak aberrant CD25+, CD63+/++++het. Mutation of the c-kit gene was observed (D816V) in mast cells, but not in CD34 cells or eosinophils. Subsequently, she was referred to rheumatology due to osteopenia detected in a bone densitometry with risk of hip fracture. The treatment with bisphosphonates (BP) (pamidronate, etidronate, zoledronate, etc.) was discarded due to being harmful to the distal third of the oesophagus. For this reason, another antiresorptive agent, denosumab (Prolia® was chosen), (non-chimeric) human monoclonal antibody (IgG2), which binds with great affinity and specificity to the receptor activator of nuclear factor kappa-B ligand (RANKL), preventing the activation of its RANK receptor on the surface of the osteoclast precursors and in osteoclasts, inhibiting osteoclastic action and therefore causing a decrease in bone resorption.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> A two-year treatment with denosumab (a subcutaneous dose every 6 months) was initiated, and the medication had to be discontinued when the patient experienced pain and suppuration in the upper left jaw, which is why she was referred to the oral and maxillofacial surgery service. On clinical examination, necrotic bone exposure was observed in the described location of approx. 2<span class="elsevierStyleHsp" style=""></span>cm in diameter, starting treatment with amoxicillin 1<span class="elsevierStyleHsp" style=""></span>g/8<span class="elsevierStyleHsp" style=""></span>h for one week and meticulous oral hygiene with 12% chlorhexidine mouthwash/3 times a day. An imaging study was also performed using computerized axial tomography (CAT) that showed extensive osteonecrosis of the jaw (ONJ) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). BP-related ONJ is widely collected in the scientific literature; some cases of ONJ have recently been described in relation to the use of denosumab, with Neuprez et al. reporting the first case of ONJ in a patient with osteoporosis after a dental extraction.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> Although denosumab, unlike BP, lacks anti-angiogenic activity, 3 clinical trials with denosumab (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>52) showed an increased risk of developing osteonecrosis of the jaw compared to zoledronic acid (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>37), with a 1.4:1 ratio (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05).<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> Although the medical literature shows that the risk of developing ONJ in patients exposed to oral BP or denosumab in the treatment of osteoporosis is real, it continues to be low. The cases described are explained by the high number of patients (5.1 million over 55 years of age) exposed to these drugs. However, as denosumab does not incorporated into bone matrix, the cases of ONJ could cure with a higher success rate, as shown by the stabilization of the process in the case reported, where, after the administration of antibiotherapy and a meticulous oral hygiene, the symptoms have disappeared, exclusively persisting the intraoral necrotic bone exposure after one year of follow-up.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sánchez López JD, Cariati P, Pérez de Perceval Tara M. Osteonecrosis maxilar asociada a tratamiento con denosumab en una paciente con mastocitosis sistémica. Med Clin (Barc). 2018;151:81–82.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 972 "Ancho" => 750 "Tamanyo" => 36333 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Area of osteonecrosis and osteolysis in the left jaw with bone sequestrum (the arrow represents the lesion).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mastocitosis ósea. Aproximación al diagnóstico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.B. Sánchez Montero" 1 => "L.M. Vaquero Roncero" 2 => "M. Arias Paciencia" 3 => "P.F. Rodríguez Robina" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Med Inter" "fecha" => "2000" "volumen" => "17" "paginaInicial" => "267" "paginaFinal" => "273" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0030" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology and pathogenesis of osteonecrosis of the jaw" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "I.R. Reid" 1 => "J. Cornish" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nrrheum.2011.181" "Revista" => array:6 [ "tituloSerie" => "Nat Rev Rheumatol" "fecha" => "2011" "volumen" => "8" "paginaInicial" => "90" "paginaFinal" => "96" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22124271" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0035" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteonecrosis of the jaw in a male osteoporotic patient treated with denosumab" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Neuprez" 1 => "S. Coste" 2 => "E. Rompen" 3 => "J.M. Crielaard" 4 => "J.Y. Reginster" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-013-2437-z" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2014" "volumen" => "25" "paginaInicial" => "393" "paginaFinal" => "395" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23835864" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0040" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence, risk factors, and outcomes of osteonecrosis of the jaw: Integrated analysis from three blinded active-controlled phase III trials in cancer patients with bone metastases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Saad" 1 => "J.E. Brown" 2 => "C. van Poznak" 3 => "T. Ibrahim" 4 => "S.M. Stemmer" 5 => "A.T. Stopeck" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/annonc/mdr435" "Revista" => array:6 [ "tituloSerie" => "Ann Oncol" "fecha" => "2012" "volumen" => "23" "paginaInicial" => "1341" "paginaFinal" => "1347" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21986094" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015100000002/v1_201807220502/S2387020618302110/v1_201807220502/en/main.assets" "Apartado" => array:4 [ "identificador" => "43311" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015100000002/v1_201807220502/S2387020618302110/v1_201807220502/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020618302110?idApp=UINPBA00004N" ]
Journal Information
Vol. 151. Issue 2.
Pages 81-82 (July 2018)
Share
Download PDF
More article options
Vol. 151. Issue 2.
Pages 81-82 (July 2018)
Scientific letter
Maxillar osteonecrosis associated to denosumab in a patient with systemic mastocytosis
Osteonecrosis maxilar asociada a tratamiento con denosumab en una paciente con mastocitosis sistémica
Visits
5
José Darío Sánchez López
, Paolo Cariati, Miguel Pérez de Perceval Tara
Corresponding author
Servicio de Cirugía Oral y Maxilofacial, Hospital Universitario Virgen de las Nieves, Granada, Spain
This item has received
Article information
These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscribe
Purchase
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail