# Severe Systemic Arthralgia After Zoledronic Acid Infusion in a Patient With Thyroid Dysfunction and Osteoporosis

**Authors:** Meumbur P Kpughur-Tule, Carly M Hubers, Kendall Conway, Reshma Reguram, Alexander M Satei, Durga Yerasuri

PMC · DOI: 10.7759/cureus.83198 · Cureus · 2025-04-29

## TL;DR

A 72-year-old woman with thyroid issues and osteoporosis experienced severe joint pain and inflammation after a zoledronic acid infusion.

## Contribution

This paper reports a novel case of severe systemic arthralgia following zoledronic acid in a patient with complex endocrine comorbidities.

## Key findings

- Severe systemic inflammatory reactions can occur after zoledronic acid infusion.
- Patients with complex endocrine conditions may be at higher risk for such adverse effects.

## Abstract

Zoledronic acid (Reclast) is a commonly used bisphosphonate for the management of osteoporosis, but severe systemic inflammatory reactions following administration are uncommon. We report the case of a 72-year-old female who developed a novel case of severe arthralgia and systemic inflammatory symptoms following a single zoledronic acid infusion. This reaction occurred in the setting of newly diagnosed hyperthyroidism following prior hypothyroidism, uncontrolled hypertension, and osteoporosis. This case highlights the importance of recognizing severe systemic inflammatory reactions as a potential adverse effect of bisphosphonate therapy, particularly in patients with complex endocrine and metabolic comorbidities.

## Linked entities

- **Chemicals:** Zoledronic acid (PubChem CID 68740)
- **Diseases:** osteoporosis (MONDO:0005298), hyperthyroidism (MONDO:0004425), hypothyroidism (MONDO:0005420)

## Full-text entities

- **Diseases:** Osteoporosis (MESH:D010024), hyperthyroidism (MESH:D006980), hypothyroidism (MESH:D007037), Thyroid Dysfunction (MESH:D013959), Systemic Arthralgia (MESH:D018771), hypertension (MESH:D006973), inflammatory (MESH:D007249)
- **Chemicals:** Zoledronic Acid Infusion (-), bisphosphonate (MESH:D004164), Reclast (MESH:D000077211)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12121932/full.md

## References

11 references — full list in the complete paper: https://tomesphere.com/paper/PMC12121932/full.md

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Source: https://tomesphere.com/paper/PMC12121932