Rituximab as a trigger factor of medication-related osteonecrosis of the jaw. A case report.

Abstract:

:Rituximab, an anti-CD20 monoclonal antibody, is an effective treatment for rheumatoid arthritis. Here we report the case of a patient with rheumatoid arthritis, having taken risedronate for 14 months to prevent corticosteroid-induced osteoporosis, more than 2 years ago, who presented osteonecrosis of jaw following herpetic gingivostomatitis two weeks after the beginning of a rituximab treatment associated with her usual anti-rheumatic drugs. Eight weeks later, no bone and/or gum healing was observed and a stage 2 medication-related osteonecrosis of the jaw (MRONJ) was diagnosed. A conservative approach was decided with antiseptic mouth washes, low-level laser treatment (LLLT) and systemic therapy with teriparatide. Complete mucosal coverage was obtained after more two years of follow-up. We suggest that rituximab as immunosuppressant might be a cause or a decompensating factor of MRONJ. Non-surgical periodontal treatment with LLLT and teriparatide are candidates for the treatment of MRONJ.

authors

Javelot MJ,Sergheraert J,Agbo-Godeau S,Levy-Weil F,Laurence S,Goudot P,Khonsari RH,Mauprivez C

doi

10.1016/j.jormas.2019.06.009

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

300-304

issue

3

eissn

2468-8509

issn

2468-7855

pii

S2468-7855(19)30168-5

journal_volume

121

pub_type

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