Serraino Cristina, Melchio Remo, Silvestri Alberto, Borretta Valentina, Pomero Fulvio, Fenoglio Luigi
Department of Internal Medicine, S. Croce e Carle General Hospital, Cuneo, Italy.
Intern Med. 2015;54(7):777-83. doi: 10.2169/internalmedicine.54.3448. Epub 2015 Apr 1.
Hepatitis C-associated osteosclerosis (HCAO) is an uncommon condition characterized by increased bone density, skeletal pain and elevated bone formation markers. Since 1992, only 17 cases have been reported. We herein describe the case of a 61-year-old woman affected by severe pain involving the lower limbs. The laboratory data showed an elevated serum alkaline phosphatase level, and the patient was found to be seropositive for hepatitis C virus infection. In addition, an X-ray skeleton survey showed marked cortical thickening of both femurs and tibias, and a whole-body bone scan revealed an increased cortical radionuclide uptake in the involved bones. These findings were consistent with a diagnosis of HCAO. In this report, we discuss the patient's clinical course over 16 years and, for the first time, show a normalized radioisotope uptake on bone scanning 10 years after the diagnosis.
丙型肝炎相关性骨硬化症（HCAO）是一种罕见病症，其特征为骨密度增加、骨骼疼痛以及骨形成标志物升高。自1992年以来，仅报告了17例病例。我们在此描述一名61岁女性的病例，她患有涉及下肢的剧痛。实验室数据显示血清碱性磷酸酶水平升高，且该患者丙型肝炎病毒感染血清学呈阳性。此外，X线骨骼检查显示双侧股骨和胫骨皮质明显增厚，全身骨扫描显示受累骨骼的皮质放射性核素摄取增加。这些发现符合HCAO的诊断。在本报告中，我们讨论了该患者16年的临床病程，并首次展示了诊断10年后骨扫描放射性同位素摄取恢复正常的情况。
