Diamond T, Depczynski B
Department of Endocrinology, St. George Hospital, Kogarah, Australia.
Bone. 1996 Dec;19(6):679-83. doi: 10.1016/s8756-3282(96)00304-3.
Hepatitis C has recently been recognized as a secondary cause of osteosclerosis; a further example, the first outside of North America, is described. A 37-year-old man with a history of intravenous drug use and known to be hepatitis C antibody positive presented with bone pain. Radiographs and magnetic resonance imaging demonstrated an increase in cortical and trabecular bone that on biopsy was of a normal lamellar pattern but markedly sclerotic. Biochemical markers of bone formation (serum osteocalcin) and resorption (urinary hydroxyproline excretion rate) were both markedly elevated. Pain lessened following administration of pamidronate. Biochemical markers of bone turnover fell towards their reference ranges 12 months after initiating pamidronate therapy but without significant change in bone mineral density. Osteosclerosis is a rare complication of hepatitis C infection, the symptoms of which are controllable with diphosphonate therapy.
丙型肝炎最近被认为是骨硬化的一个次要原因；本文描述了另外一个病例，这是北美以外的首个此类病例。一名37岁有静脉吸毒史且已知丙型肝炎抗体呈阳性的男子出现骨痛。X线片和磁共振成像显示皮质骨和小梁骨增加，活检显示为正常板层模式但明显硬化。骨形成（血清骨钙素）和骨吸收（尿羟脯氨酸排泄率）的生化标志物均显著升高。给予帕米膦酸后疼痛减轻。开始帕米膦酸治疗12个月后，骨转换的生化标志物降至参考范围，但骨矿物质密度无显著变化。骨硬化是丙型肝炎感染的一种罕见并发症，其症状可用双膦酸盐治疗控制。
