Three Years Follow-up of Pamidronate Therapy in Two Brothers with Osteoporosis-Pseudoglioma Syndrome (OPPG) Carrying an LRP5 Mutation

Osteoporosis-pseudoglioma (OPPG) is a rare syndrome characterized by severe osteoporosis and ocular defects caused by homozygotic inactivation mutations in the LRP5 gene. Bisphosphonate has been demonstrated to improve bone mineral density (BMD) in children with OPPG. We present here a 3 years follo...

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Veröffentlicht in:Journal of Pediatric Endocrinology and Metabolism 2008-08, Vol.21 (8), p.811-818
Hauptverfasser: Barros, E.R., Dias da Silva, M.R., Kunii, I.S., Lazaretti-Castro, M.
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container_issue 8
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container_title Journal of Pediatric Endocrinology and Metabolism
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creator Barros, E.R.
Dias da Silva, M.R.
Kunii, I.S.
Lazaretti-Castro, M.
description Osteoporosis-pseudoglioma (OPPG) is a rare syndrome characterized by severe osteoporosis and ocular defects caused by homozygotic inactivation mutations in the LRP5 gene. Bisphosphonate has been demonstrated to improve bone mineral density (BMD) in children with OPPG. We present here a 3 years follow-up of two brothers with OPPG carrying a novel mutation in the LRP5 gene, who were treated with intravenous pamidronate. We looked for a mutation in the LRP5 gene in two brothers (12 and 4 years old) with clinical features of OPPG (blindness, low BMD and fragility fractures) and in their consanguineous parents to confirm the diagnosis of OPPG. The patients were treated with bisphosphonate for 3 years. They received 1 mg/kg/day of pamidronate for 2 consecutive days, every 3 months during the first year, and every 4 months in subsequent years. Calcium, phosphorus, total alkaline phosphatase, parathyroid hormone, hepatic transaminases, creatinine and hemogram tests were performed before each infusion. Bone densitometry was performed at baseline and at the end of the follow-up. The affected brothers carry a missense mutation in the third codon of exon 8 (AAT-->ATT) that led to the exchange of an asparagine for an isoleucine (N531I). Both parents were found to be heterozygous for this mutation. The intravenous pamidronate therapy was safe for up to 3 years of use. Moreover, increased BMD and decreased fracture rate were observed in our patients with OPPG.
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Bisphosphonate has been demonstrated to improve bone mineral density (BMD) in children with OPPG. We present here a 3 years follow-up of two brothers with OPPG carrying a novel mutation in the LRP5 gene, who were treated with intravenous pamidronate. We looked for a mutation in the LRP5 gene in two brothers (12 and 4 years old) with clinical features of OPPG (blindness, low BMD and fragility fractures) and in their consanguineous parents to confirm the diagnosis of OPPG. The patients were treated with bisphosphonate for 3 years. They received 1 mg/kg/day of pamidronate for 2 consecutive days, every 3 months during the first year, and every 4 months in subsequent years. Calcium, phosphorus, total alkaline phosphatase, parathyroid hormone, hepatic transaminases, creatinine and hemogram tests were performed before each infusion. Bone densitometry was performed at baseline and at the end of the follow-up. 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subjects Antineoplastic Agents - therapeutic use
Blindness - complications
Blindness - congenital
Blindness - genetics
Bone Density - drug effects
Bone Density Conservation Agents - therapeutic use
Child
Child, Preschool
Consanguinity
Diphosphonates - therapeutic use
Follow-Up Studies
Fractures, Bone - prevention & control
Humans
LDL-Receptor Related Proteins - genetics
Low Density Lipoprotein Receptor-Related Protein-5
Male
Mutation
Osteoporosis - complications
Osteoporosis - genetics
Pamidronate
Pedigree
Siblings
Syndrome
title Three Years Follow-up of Pamidronate Therapy in Two Brothers with Osteoporosis-Pseudoglioma Syndrome (OPPG) Carrying an LRP5 Mutation
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