Symptomatic and scintigraphic improvement after intravenous pamidronate treatment of Paget's disease of bone in patients with normal serum alkaline phosphatase levels
To describe three patients with symptomatic Paget's disease of bone who presented with normal levels of serum alkaline phosphatase. We present three cases of Paget's disease of bone and chronicle the laboratory, scintigraphic, and clinical findings relative to treatment with intravenously...
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| Veröffentlicht in: | Endocrine practice 2003-07, Vol.9 (4), p.280-283 |
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| creator | Ang, George Feiglin, David Moses, Arnold M |
| description | To describe three patients with symptomatic Paget's disease of bone who presented with normal levels of serum alkaline phosphatase.
We present three cases of Paget's disease of bone and chronicle the laboratory, scintigraphic, and clinical findings relative to treatment with intravenously administered pamidronate.
Although measurement of serum total alkaline phosphatase usually provides a general indication of bone turnover in Paget's disease, about 15% of patients present with normal serum alkaline phosphatase levels. Nonetheless, these patients may have active Paget's disease when assessed with bone scintigraphy or urinary markers of bone resorption. All three study patients had xray findings characteristic of Paget's disease of bone, increased uptake of radiotracer material on bone scans, and elevated levels of urinary markers of bone resorption but normal alkaline phosphatase levels. They were treated with intravenously administered pamidronate, 60 mg once weekly for 2 to 3 consecutive weeks. After treatment, the serum alkaline phosphatase level decreased by 19 to 36%, markers of bone resorption normalized, bone scans showed improvement, and bone pain resolved.
Pagetic activity in bone and related clinical manifestations may be present in the setting of a normal serum alkaline phosphatase level. Appropriate therapy should not be withheld because of the normal alkaline phosphatase. |
| doi_str_mv | 10.4158/ep.9.4.280 |
| format | Article |
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We present three cases of Paget's disease of bone and chronicle the laboratory, scintigraphic, and clinical findings relative to treatment with intravenously administered pamidronate.
Although measurement of serum total alkaline phosphatase usually provides a general indication of bone turnover in Paget's disease, about 15% of patients present with normal serum alkaline phosphatase levels. Nonetheless, these patients may have active Paget's disease when assessed with bone scintigraphy or urinary markers of bone resorption. All three study patients had xray findings characteristic of Paget's disease of bone, increased uptake of radiotracer material on bone scans, and elevated levels of urinary markers of bone resorption but normal alkaline phosphatase levels. They were treated with intravenously administered pamidronate, 60 mg once weekly for 2 to 3 consecutive weeks. After treatment, the serum alkaline phosphatase level decreased by 19 to 36%, markers of bone resorption normalized, bone scans showed improvement, and bone pain resolved.
Pagetic activity in bone and related clinical manifestations may be present in the setting of a normal serum alkaline phosphatase level. Appropriate therapy should not be withheld because of the normal alkaline phosphatase.</description><identifier>ISSN: 1530-891X</identifier><identifier>EISSN: 1934-2403</identifier><identifier>DOI: 10.4158/ep.9.4.280</identifier><identifier>PMID: 14561571</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Aged ; Alkaline Phosphatase - blood ; Diphosphonates - therapeutic use ; Female ; Femur - diagnostic imaging ; Femur - pathology ; Humans ; Ilium - diagnostic imaging ; Ilium - pathology ; Injections, Intravenous ; Male ; Osteitis Deformans - diagnostic imaging ; Osteitis Deformans - drug therapy ; Osteitis Deformans - enzymology ; Pamidronate ; Pelvis - diagnostic imaging ; Pelvis - pathology ; Radionuclide Imaging</subject><ispartof>Endocrine practice, 2003-07, Vol.9 (4), p.280-283</ispartof><rights>Copyright Allen Press Publishing Services Jul/Aug 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c259t-fb564a30aeb45740177dc6fb0268ba1499afacf3dd05f6e9ad3d0a7c3f504f2d3</citedby><cites>FETCH-LOGICAL-c259t-fb564a30aeb45740177dc6fb0268ba1499afacf3dd05f6e9ad3d0a7c3f504f2d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1695373302?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14561571$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ang, George</creatorcontrib><creatorcontrib>Feiglin, David</creatorcontrib><creatorcontrib>Moses, Arnold M</creatorcontrib><title>Symptomatic and scintigraphic improvement after intravenous pamidronate treatment of Paget's disease of bone in patients with normal serum alkaline phosphatase levels</title><title>Endocrine practice</title><addtitle>Endocr Pract</addtitle><description>To describe three patients with symptomatic Paget's disease of bone who presented with normal levels of serum alkaline phosphatase.
We present three cases of Paget's disease of bone and chronicle the laboratory, scintigraphic, and clinical findings relative to treatment with intravenously administered pamidronate.
Although measurement of serum total alkaline phosphatase usually provides a general indication of bone turnover in Paget's disease, about 15% of patients present with normal serum alkaline phosphatase levels. Nonetheless, these patients may have active Paget's disease when assessed with bone scintigraphy or urinary markers of bone resorption. All three study patients had xray findings characteristic of Paget's disease of bone, increased uptake of radiotracer material on bone scans, and elevated levels of urinary markers of bone resorption but normal alkaline phosphatase levels. They were treated with intravenously administered pamidronate, 60 mg once weekly for 2 to 3 consecutive weeks. After treatment, the serum alkaline phosphatase level decreased by 19 to 36%, markers of bone resorption normalized, bone scans showed improvement, and bone pain resolved.
Pagetic activity in bone and related clinical manifestations may be present in the setting of a normal serum alkaline phosphatase level. Appropriate therapy should not be withheld because of the normal alkaline phosphatase.</description><subject>Aged</subject><subject>Alkaline Phosphatase - blood</subject><subject>Diphosphonates - therapeutic use</subject><subject>Female</subject><subject>Femur - diagnostic imaging</subject><subject>Femur - pathology</subject><subject>Humans</subject><subject>Ilium - diagnostic imaging</subject><subject>Ilium - pathology</subject><subject>Injections, Intravenous</subject><subject>Male</subject><subject>Osteitis Deformans - diagnostic imaging</subject><subject>Osteitis Deformans - drug therapy</subject><subject>Osteitis Deformans - enzymology</subject><subject>Pamidronate</subject><subject>Pelvis - diagnostic imaging</subject><subject>Pelvis - pathology</subject><subject>Radionuclide Imaging</subject><issn>1530-891X</issn><issn>1934-2403</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp90c2KFDEQB_BGFHddvfgAEhBUhBnz2d05yrJ-wIILKngL1Z3KTtZOp03SI_tCPqcZd0Dw4Cmh8qsif6ppnjK6lUz1b3DZ6q3c8p7ea06ZFnLDJRX3610Juuk1-3bSPMr5hlJONesfNidMqpapjp02vz7fhqXEAMWPBGZL8ujn4q8TLLta8WFJcY8B50LAFUykvibY4xzXTBYI3qY4Q0FSEkL546IjV3CN5WUm1meEjIfSEGeszbWn-Koy-enLjswxBZhIxrQGAtN3mHxlyy7mZQfl0DrhHqf8uHngYMr45HieNV_fXXw5_7C5_PT-4_nby83IlS4bN6hWgqCAg1SdpKzr7Ni6gfK2H4BJrcHB6IS1VLkWNVhhKXSjcIpKx604a17cza2xf6yYiwk-jzhNMGNNbDrGe0HbrsJX_4Ws553mtP6h0uf_0Ju4prnGMKzVSnRCUF7V6zs1pphzQmeW5AOkW8OoOazZXFwZbaSpa6742XHkOgS0f-lxr-I3vuynYA</recordid><startdate>200307</startdate><enddate>200307</enddate><creator>Ang, George</creator><creator>Feiglin, David</creator><creator>Moses, Arnold M</creator><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7QP</scope><scope>7X8</scope></search><sort><creationdate>200307</creationdate><title>Symptomatic and scintigraphic improvement after intravenous pamidronate treatment of Paget's disease of bone in patients with normal serum alkaline phosphatase levels</title><author>Ang, George ; Feiglin, David ; Moses, Arnold M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c259t-fb564a30aeb45740177dc6fb0268ba1499afacf3dd05f6e9ad3d0a7c3f504f2d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Aged</topic><topic>Alkaline Phosphatase - blood</topic><topic>Diphosphonates - therapeutic use</topic><topic>Female</topic><topic>Femur - diagnostic imaging</topic><topic>Femur - pathology</topic><topic>Humans</topic><topic>Ilium - diagnostic imaging</topic><topic>Ilium - pathology</topic><topic>Injections, Intravenous</topic><topic>Male</topic><topic>Osteitis Deformans - diagnostic imaging</topic><topic>Osteitis Deformans - drug therapy</topic><topic>Osteitis Deformans - enzymology</topic><topic>Pamidronate</topic><topic>Pelvis - diagnostic imaging</topic><topic>Pelvis - pathology</topic><topic>Radionuclide Imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ang, George</creatorcontrib><creatorcontrib>Feiglin, David</creatorcontrib><creatorcontrib>Moses, Arnold M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Endocrine practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ang, George</au><au>Feiglin, David</au><au>Moses, Arnold M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Symptomatic and scintigraphic improvement after intravenous pamidronate treatment of Paget's disease of bone in patients with normal serum alkaline phosphatase levels</atitle><jtitle>Endocrine practice</jtitle><addtitle>Endocr Pract</addtitle><date>2003-07</date><risdate>2003</risdate><volume>9</volume><issue>4</issue><spage>280</spage><epage>283</epage><pages>280-283</pages><issn>1530-891X</issn><eissn>1934-2403</eissn><abstract>To describe three patients with symptomatic Paget's disease of bone who presented with normal levels of serum alkaline phosphatase.
We present three cases of Paget's disease of bone and chronicle the laboratory, scintigraphic, and clinical findings relative to treatment with intravenously administered pamidronate.
Although measurement of serum total alkaline phosphatase usually provides a general indication of bone turnover in Paget's disease, about 15% of patients present with normal serum alkaline phosphatase levels. Nonetheless, these patients may have active Paget's disease when assessed with bone scintigraphy or urinary markers of bone resorption. All three study patients had xray findings characteristic of Paget's disease of bone, increased uptake of radiotracer material on bone scans, and elevated levels of urinary markers of bone resorption but normal alkaline phosphatase levels. They were treated with intravenously administered pamidronate, 60 mg once weekly for 2 to 3 consecutive weeks. After treatment, the serum alkaline phosphatase level decreased by 19 to 36%, markers of bone resorption normalized, bone scans showed improvement, and bone pain resolved.
Pagetic activity in bone and related clinical manifestations may be present in the setting of a normal serum alkaline phosphatase level. Appropriate therapy should not be withheld because of the normal alkaline phosphatase.</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>14561571</pmid><doi>10.4158/ep.9.4.280</doi><tpages>4</tpages></addata></record> |
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| subjects | Aged Alkaline Phosphatase - blood Diphosphonates - therapeutic use Female Femur - diagnostic imaging Femur - pathology Humans Ilium - diagnostic imaging Ilium - pathology Injections, Intravenous Male Osteitis Deformans - diagnostic imaging Osteitis Deformans - drug therapy Osteitis Deformans - enzymology Pamidronate Pelvis - diagnostic imaging Pelvis - pathology Radionuclide Imaging |
| title | Symptomatic and scintigraphic improvement after intravenous pamidronate treatment of Paget's disease of bone in patients with normal serum alkaline phosphatase levels |
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