A Mimicker:  An Acute Phase Reaction from Zoledronate Mimicking Symptoms seen in Opioid Withdrawal

 

Introduction

• Zoledronate, a bisphosphonate, preferred treatment for hypercalcemia when unresponsive to intravenous fluids.1

• Bisphosphonates can cause transient acute phase reaction consisting of fevers, chills, myalgias, arthralgias, and headaches.2,3 Mimic opioid withdrawal symptoms.

Our case highlights cognitive bias involving a patient with opioid use disorder who received zoledronate for hypercalcemia secondary to immobilization and significant bone infection.