Rheumatology Department, USAF Wright Patterson Medical Center, Wright-Patterson AFB, OH 45433, USA.
Mil Med. 2023 Jul 22;188(7-8):e2802-e2804. doi: 10.1093/milmed/usac245.
Osteogenesis imperfecta (OI) is a heritable, collagen-related disorder with varying degrees of disease severity and systemic involvement. The hallmark of OI is bone matrix fragility, but diverse effects related to structural integrity and impaired development of connective tissue can account for hearing loss, blue sclera, dentinogenesis imperfecta, frequent fractures, joint hypermobility, and cardiac valve or vessel fragility in some cases. There is emerging recognition of unique genetic mutations leading to OI including CREB3L1, which codes for an important transcription factor for differentiation of osteoblasts.
We present a case of OI diagnosed in an active duty female with multiple prior fractures and heterozygous CREB3L1, a rare cause of OI.
This case highlights the importance of consideration of the variable phenotypes of OI and careful assessment of fracture history during evaluation at the Military Entrance Processing Station and subsequent encounters at military treatment facilities to improve readiness.
成骨不全症(OI)是一种遗传性、与胶原相关的疾病,其严重程度和全身性受累程度不一。OI 的标志是骨基质脆弱,但与结构完整性和结缔组织发育受损相关的多种影响可导致听力损失、蓝巩膜、牙本质发育不全、频繁骨折、关节过度活动以及某些情况下的心脏瓣膜或血管脆弱。目前已经认识到一些独特的基因突变会导致 OI,包括 CREB3L1,它编码一个对成骨细胞分化很重要的转录因子。
我们介绍了一名现役女性 OI 病例,该患者有多次骨折和 CREB3L1 杂合子,这是 OI 的罕见病因。
该病例强调了在军事入伍体检站评估和随后在军事医疗设施就诊时,考虑 OI 的各种表型以及仔细评估骨折病史的重要性,以提高战备状态。