Voriconazole-associated periostitis: Pathophysiology, risk factors, clinical manifestations, diagnosis, and management

DOI

10.5500/wjt.v11.i9.356

Authors

Anthony J. Guarascio, Department of Pharmacy, Duquesne University School of Pharmacy, Pittsburgh, PA 15282, United States.
Nitin Bhanot, Division of Infectious Disease, Medicine Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, United States.
Zaw Min, Division of Infectious Disease, Medicine Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, United States. zaw.min@ahn.org.

Document Type

Journal Article

Publication Date

9-18-2021

Publication Title

World journal of transplantation

Volume

11

Issue

9

First Page

356

Last Page

371

ISSN

2220-3230

Keywords

Alkaline phosphatase, Fluoride, Fluorosis, Periostitis, Voriconazole

Abstract

Voriconazole use has been associated with osteoarticular pain and periostitis, likely due to high fluoride content in the drug formulation. This phenomenon has been described primarily with high dosage or prolonged course of voriconazole therapy in immunocompromised and transplant patient populations. Patients typically present with diffuse bony pains associated with elevated serum alkaline phosphatase and plasma fluoride levels in conjunction with radiographic findings suggestive of periostitis. We provide a comprehensive review of the literature to highlight salient characteristics commonly associated with voriconazole-induced periostitis.

Open Access

Gold

Repository Citation

Guarascio, A. J., Bhanot, N., & Min, Z. (2021). Voriconazole-associated periostitis: Pathophysiology, risk factors, clinical manifestations, diagnosis, and management. World journal of transplantation, 11 (9), 356-371. https://doi.org/10.5500/wjt.v11.i9.356