Two Cases of Monostotic Paget's Disease: Effects of Bisphosphonate

Endocrine Journal

Takeshi HARADA¹  Akiyoshi NISHIMURA¹  Hiroshi IWAI¹  Norihiko AOKI¹  Yasuhiro OHNO¹  Madoka HOSHIRO¹  Toshiyuki MIYATAKE¹ 

[1] Department of Endocrinology, Metabolism and Diabetes Mellitus, Kinki University School of Medicine

关键词: Paget's disease of bone;    Bone turnover markers;    Bisphosphonate;   

DOI  :  10.1507/endocrj.50.385

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(22)Cited-By(3)We report two cases of monostotic Paget's disease which were effectively treated with bisphosphonate. Case 1 was a 60-year-old female. Medical examination revealed high alkaline phosphatase (ALP) levels making her visit our clinic. Hematological examination showed high levels of ALP isozyme 3 and bone metabolism markers, and bone scintigraphy demonstrated strong accumulation of 99mTc on the skull. With the diagnosis of monostotic Paget's disease of the skull, treatment with bisphosphonate (etidronate) was started. The response to etidronate was good and after 12 weeks of treatment, the ALP levels decreased to about 26% of the levels before treatment, without the appearance of any symptoms or lesion development. One year and three months later, ALP increased again, and etidronate administration was resumed. However, four years after the diagnosis of the disease, etidronate became ineffective and oral administration of alendronate, a stronger bisphosphonate, was started at 5 mg/day. The patient responded favorably to the bisphosphonate and is still under observation. Case 2 was a 71-year-old female. High ALP levels were found during the follow-up of type 2 diabetes, and the case was diagnosed as monostotic Paget's disease of the pelvis based on bone metabolism markers and bone scintigraphy. Etidronate treatment at 200 mg/day resulted in the improvement of bone metabolism markers and bone scintigraphy findings. When she died of colon cancer twelve months later, with no marked progress of the Paget's disease of bone observed clinically.

【 授权许可】

Unknown