Pinto Christopher Jude, Maldar Shadab B, Hegde Siddhi, Choukimath Sharanabasav M
Department of Medicine, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.
Western Michigan University, Homer Stryker M.D School of Medicine, Battle Creek, MI, USA.
Radiol Case Rep. 2024 Feb 23;19(5):1886-1892. doi: 10.1016/j.radcr.2024.01.037. eCollection 2024 May.
Paget's disease of bone is a disorder of osteoclasts which hampers the physiological process of bone remodeling. It is the most common metabolic orthopedic disease in the Caucasian populace; we report the diagnosis of Paget's disease of bone in a South-Asian male in his early 50s with a history of gastrointestinal symptoms, weight loss and back pain. An alkaline phosphatase level of 1104 IU/L was noted. A 3-phase bone scan showed noncontiguous heterogenous nuclear uptake. After exhaustive evaluation, the patient was diagnosed with Paget's disease of bone. Despite the disease activity being mitigated by alendronate and monitored by ALP levels within normal range per protocol, the patient had compression fractures of the vertebrae requiring early reinitiation of oral bisphosphonates. This raised doubts about the efficacy of metabolic marker-based management in Paget's disease of bone.
骨佩吉特病是一种破骨细胞疾病，会妨碍骨重塑的生理过程。它是白种人群中最常见的代谢性骨科疾病；我们报告了一名50岁出头的南亚男性被诊断为骨佩吉特病，他有胃肠道症状、体重减轻和背痛病史。碱性磷酸酶水平为1104 IU/L。三相骨扫描显示不连续的异质性核摄取。经过详尽评估，该患者被诊断为骨佩吉特病。尽管疾病活动通过阿仑膦酸盐得到缓解，并按照方案通过碱性磷酸酶水平监测在正常范围内，但该患者仍发生了椎体压缩骨折，需要早期重新开始口服双膦酸盐治疗。这引发了对基于代谢标志物管理骨佩吉特病疗效的质疑。
