A case of BRONJ caused by rapidly progressive glomerulonephritis

Abstract

We report a case of bisphosphonate-related osteonecrosis of the jaw (BRONJ) complicated by rapidly progressive glomerulonephritis (PRGN). A 68-year-old woman was referred to our department because of right submandibular swelling. She had received methotrexate, inflimaxive, and arendronate sodium hydrate for rheumatoid arthritis. After extraction of the right mandibular first molar, she received steroid therapy for a leg ulcer, and osteonecrosis of the mandible occurred. During conservative treatment, her creatinine level became 3.34 mg/dl. She was hospitalized to control renal function and given a diagnosis of rapidly progressive glomerulonephritis associated with mandibular infection. We performed segmental resection with mandibular reconstruction using a titanium plate. Renal dysfunction started to improve after opertion, and BRONJ was cured.