paget's%20bone%20disease
PAGET'S BONE DISEASE
Paget's bone disease, also known as osteitis deformans, is characterized by a significant increase in bone resorption and turnover in localized parts of the skeleton causing enlargement and thickening of the bone that is disordered and architecturally unstable.
The prevalence increases with age, with men and women affected equally.
Genetic factors and/or viral infection may play a role in the etiology.
May affect one bone (monostotic) or several bones (polyostotic).
By decreasing frequency, involved bones may include pelvic bone and sacrum, spine, skull and femur, tibia, humeri and clavicles.

Follow Up

Frequency & extent of follow-up will depend upon severity of disease

  • Monitor serum ALP every 3-6 months to determine the biochemical response to bisphosphonate therapy
    • Once the value of serum ALP plateaus after 3-6 months of assessment, it can be measured 1-2x/year as a marker of bone activity
  • A more specific bone formation/resorption marker other than ALP (ie amino-terminal propeptide of type 1 collagen [P1NP], βC-terminal propeptide of type-1 collagen [βCTx], N-terminal propeptide of type 1 collagen [NTx] assay) may be measured for patients w/ monostatic Paget’s disease
  • Serial imaging tests (eg bone scan) are not generally useful in routine monitoring of treatment response
    • Bone scan may be helpful in monitoring treatment response after 6-12 months of treatment in patients w/ monostotic disease
  • If treatment failure is apparent consider re-treatment 6 months after the initial therapy for the following:
    • Symptom relapse or persistence
    • >25% above nadir of serum ALP in asymptomatic patient
  • Long-term evolution increases the risk for osteosarcoma on pagetic bone
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Endocrinology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
03 Sep 2018
Dietary nicotinamide riboside (NR) supplementation in 2,000-mg doses daily over a 12-week period is safe, a recent study has shown. However, it does not improve insulin sensitivity and whole-body glucose metabolism in obese, insulin-resistant men.
01 Oct 2015
Type 1 diabetes mellitus occurrence among the paediatric population is fast rising, especially among 5-9-year olds, based on a 26-year observational study.
07 Apr 2016
Radha Chitale spoke with Dr. Kim A. Williams, Sr., who served as the 2015-2016 president of the American College of Cardiology, during the organization's annual meeting in Chicago, Illinois, US as he reflected on his term and discussed what's exciting in cardiology. 
Dr. Joseph Delano Fule Robles, 25 Jul 2018

Prior to considering pharmacotherapy or surgery, weight reduction can be achieved through dietary modification and management of meal habits, sleep hours and stress.