[Damage to the respiratory tract due to aspirated alendronate].

We describe the rare case of a high-grade chemical irritating-toxic damage to the larynx, the trachea and the bronchial system due to the aspiration of the bisphosphonate alendronate. The aspiration of alendronate was caused by oropharyngeal dysphagia. The 68-year-old female patient was sent to hospital with increasing hoarseness and a tormenting continuous cough of high intensity. X-Ray pictures of the thorax showed dystelectasis of the right middle lobe. Severe damage to the bronchial system caused by the aspirated alendronate was demonstrated by flexible bronchoscopy. Anti-obstructive, antiphlogistic and antibiotic treatment led to a gradual improvement of the symptoms. The administration of alendronate should be avoided in cases of dysphagia. Besides the danger of oesophageal injury, there is also the risk of aspiration that can be associated with severe damage to the bronchial system as this case study demonstrates.