{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T22:00:56Z","timestamp":1763071256961,"version":"3.40.5"},"reference-count":14,"publisher":"Walter de Gruyter GmbH","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2022-0475_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Bisphosphonates are used in childhood osteoporosis but can cause an acute phase reaction (APR) and hypocalcemia. We present a child with cardiac thrombosis following zoledronate, a previously unreported complication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2022-0475_abs_002\">\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>An 11-year-old with Duchenne muscular dystrophy and steroid-induced osteoporosis presented 48\u00a0h after first zoledronate infusion with fever, tachycardia, tachypnoea and hypoglycaemia. This was managed as acute adrenal crisis and possible sepsis. He also had hypocalcemia, hypophosphatemia, hyponatraemia and hypokalaemia. Echocardiography performed due to persistent chest pain and tachycardia revealed a left ventricular thrombus.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2022-0475_abs_003\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Potential causes for intracardiac thrombosis in this patient include ventricular dysfunction due to acute adrenal crisis or electrolyte disturbance, and hypercoagulability due to the APR. Echocardiography should be considered in children with acute cardiovascular compromise following zoledronate. Stress-dose steroids to cover the APR and a reduced starting dose of zoledronate might have reduced the risk of this complication.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2022-0475","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T16:16:32Z","timestamp":1669392992000},"page":"327-330","source":"Crossref","is-referenced-by-count":5,"title":["Intracardiac thrombosis following intravenous zoledronate treatment in a child with steroid-induced osteoporosis"],"prefix":"10.1515","volume":"36","author":[{"given":"Samantha J.","family":"Case","sequence":"first","affiliation":[{"name":"Paediatric Endocrinology , Southampton Children\u2019s Hospital, University Hospital Southampton NHS Foundation Trust , Southampton , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2334-2284","authenticated-orcid":false,"given":"Rebecca J.","family":"Moon","sequence":"additional","affiliation":[{"name":"Paediatric Endocrinology , Southampton Children\u2019s Hospital, University Hospital Southampton NHS Foundation Trust , Southampton , UK"},{"name":"MRC Lifecourse Epidemiology Centre , University of Southampton , Southampton , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Bharucha","sequence":"additional","affiliation":[{"name":"Paediatric Cardiology , Southampton Children\u2019s Hospital, University Hospital Southampton NHS Foundation Trust , Southampton , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7560-6320","authenticated-orcid":false,"given":"Justin H.","family":"Davies","sequence":"additional","affiliation":[{"name":"Paediatric Endocrinology , Southampton Children\u2019s Hospital, University Hospital Southampton NHS Foundation Trust , Southampton , UK"},{"name":"Faculty of Medicine , University of Southampton , Southampton , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2022,11,28]]},"reference":[{"key":"2023033123251285120_j_jpem-2022-0475_ref_001","doi-asserted-by":"crossref","unstructured":"Birnkrant, DJ, Bushby, K, Bann, CM, Alman, BA, Apkon, SD, Blackwell, A, et al.. Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management. Lancet Neurol 2018;17:347\u201361. https:\/\/doi.org\/10.1016\/s1474-4422(18)30025-5.","DOI":"10.1016\/S1474-4422(18)30025-5"},{"key":"2023033123251285120_j_jpem-2022-0475_ref_002","unstructured":"Electronic Medicines Compendium (EMC). Zoledronic acid 4\u00a0mg\/5\u00a0mL concentrate for solution for infusion. Available from: https:\/\/www.medicines.org.uk\/emc\/product\/13761\/smpc [Accessed 17 Oct 2022]."},{"key":"2023033123251285120_j_jpem-2022-0475_ref_003","doi-asserted-by":"crossref","unstructured":"Ward, LM, Choudhury, A, Alos, N, Cabral, DA, Rodd, C, Sbrocchi, AM, et al.. Zoledronic acid vs placebo in pediatric glucocorticoid-induced osteoporosis: a randomized, double-blind, phase 3 trial. 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