経口ビスホスホネートが著効を示した反射性交感神経性ジストロフィーの1例

Treatment of Reflex Sympathetic Dystrophy with Bisphosphonate. Case Report

　反射性交感神経性ジストロフィー(reflex sympathetic dystrophy：以下RSD)に経口投与のビスホスホネートが著効した症例を報告する．症例は54歳の男性で，左下腿から足部にかけての疼痛，腫脹を訴え，著明な骨萎縮を認めた．通常の抗炎症治療に反応せず，ビスホスホネートを経口投与したところ，症状は改善し骨萎縮像も回復を示した．これまで静脈投与のビスホスホネートのRSDに対する効果は報告されているが，常用量の経口投与が奏効した報告はない．骨萎縮を呈するRSDに対して経口ビスホスホネートは治療の選択肢となる可能性がある．

　We report a case of reflex sympathetic dystrophy (RSD) in which treatment with an oral bisphosphonate was very effective.　The patient was a 54-year-old man with pain and swelling of his left leg and foot, and whose left leg and foot bones were severely atrophic.　The pain and swelling were not relieved by NSAIDs or steroids, but treatment with an oral bisphosphonate relieved his symptoms, and there was marked improvement in the bone atrophy.　There have been reports of bisphosphonate treatment of RSD by intravenous injection, but this is the first report of treatment with the standard oral dose of a bisphosphonate.　This case suggests that oral bisphosphonate therapy can be used as an alternative treatment for RSD with bone atrophy.