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Idea Transcript
Title: Treatment for the Untreatable: Are the current non-surgical medical treatments for fibrous dysplasia safe? Authors: Anna Cannone, Senior at Upper Arlington High School; Carl Backes, DO Affiliations: Doctors Hospital/Ohio Health, Nationwide Children’s Hospital Introduction: The subject of our case study is an 18 year old white female diagnosed with polyostotic fibrous dysplasia and treated with a bisphosphonate drug called pamidronate starting at the age of 2 years. Case Description: Prior to diagnosis, our patient had a bulging bump developing on the left side of her forehead- no pain was present until she was older. The doctors’ diagnosed fibrous dysplasia in the front of her cranium, throughout the sinus cavities and surrounding her left optic nerve. The main medication used to treat fibrous dysplasia is called a bisphosphonate, a group of drugs that prevent pain, isolate bone growth and avert osteoporosis. Her treatments with pamidronate were given intravenously, per her endocrinologist in Detroit, MI, every four months, three times during the month. At age 7 years the patient underwent a surgery to decompress her left optic nerve because from fibrous growth, she was going blind. The bisphosphonate which was supposed to slow down the growth of the tumor wasn’t helping. At the age of 18 years, she suffered spondylolysis from L2-L5, a consequence of the pamidronate. Discussion: Fibrous dysplasia is a rare bone disease which causes abnormal bone growth, and replaces normal bone tissue with fibrous tissue. Bisphosphonates may help but these medications need laboratory and radiologic monitoring because complications are evident in our patient from prolonged bisphosphonate treatment. Conclusion: Every patient is unique, so for future management of fibrous dysplasia updated research needs to be reviewed prior to deciding which drugs or treatment are used.