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

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.