Congestive heart failure and axonal polyneuropathy induced by alfacalcidol in a patient with systemic lupus erythematosus

We describe the case of a 29-year-old woman with systemic lupus erythematosus (SLE), who developed congestive heart failure and severe axonal polyneuropathy after 9 months of treatment with alfacalcidol for the prevention of corticosteroid-induced osteoporosis. There was no evidence for the exacerbation of SLE. Moreover, both congestive heart failure and axonal polyneuropathy improved after discontinuation of the alfacalcidol without increasing the dose of corticosteroid. Since alfacalcidol is commonly used in the prevention of corticosteroid-induced osteoporosis, rheumatologists should be aware of the presence of this life-threatening adverse effect.