Interstitial Lung Disease in a Patient Treated with Denosumab

Abstract

Denosumab is an antiresorptive agent widely used for treating osteoporosis. Atypical femur fractures, osteonecrosis of the jaw and hypocalcaemia are well-known possible adverse effects of this drug. We present, to our knowledge, the first case report in the English literature of clinically significant interstitial lung disease likely related to denosumab.

Learning points: Denosumab is a fully human monoclonal antibody which may rarely cause interstitial lung disease (ILD).The findings from this isolated case report of ILD in a patient taking denosumab do not prove causality.Nevertheless, we suggest that patient exposure to denosumab should be considered in a patient with ILD.

Keywords: Interstitial lung disease; denosumab; osteoporosis.

Figure 1

Chest high-resolution CT images in a patient with interstitial lung disease while on denosumab: axial (A), coronal (B) and sagittal (C) reconstructions show mosaic attenuation and scattered ground-glass opacities as well as mild reticulation, ill-defined lobular micronodules, and minimal architectural distortion. Note that there is no honeycombing or traction bronchiectasis