Cyclic intravenous pamidronate for an infant with osteogenesis imperfecta type II

BMJ Case Rep. 2023 May 15;16(5):e252593. doi: 10.1136/bcr-2022-252593.

Abstract

A woman in her 30s underwent a 17-week ultrasound which revealed short bowed long bones. Fetal CT at 28 weeks' gestation showed decreased ossification of the skull, a small bell-shaped thorax, hypoplastic vertebrae, and shortening and bowing of the long bones, leading to the diagnosis of osteogenesis imperfecta (OI) type II. The newborn was delivered via caesarean delivery, and tracheal intubation was performed due to the respiratory distress. A heterozygous variant in COL1A1 (c.1679G>T, p. Gly358Val) was ascertained, confirming the diagnosis of OI type II.Cyclic intravenous pamidronate was started at 41 days old with dose modification and was successfully administered every month. Currently, the infant is 8 months old without any new bone fracture. He was extubated successfully at 7 months of age and is now stable using high flow nasal cannula. The efficacy, safety, and optimal dose and timing of cyclic pamidronate for OI type II remain undefined. We report our experience of successful cyclic intravenous pamidronate treatment for an infant with OI type II.

Keywords: Calcium and bone; Musculoskeletal and joint disorders; Radiology.

Publication types

  • Case Reports

MeSH terms

  • Bone Density
  • Bone Density Conservation Agents* / therapeutic use
  • Diphosphonates / therapeutic use
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infusions, Intravenous
  • Male
  • Osteogenesis Imperfecta* / complications
  • Osteogenesis Imperfecta* / diagnostic imaging
  • Osteogenesis Imperfecta* / drug therapy
  • Pamidronate / therapeutic use

Substances

  • Pamidronate
  • Diphosphonates
  • Bone Density Conservation Agents

Supplementary concepts

  • Osteogenesis imperfecta, type 2A