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Article Dans Une Revue Morphologie Année : 2012

Osteomalacia in a patient with Paget's bone disease treated with long-term etidronate

Emmanuel Hoppé
  • Fonction : Auteur
A. Laffitte
  • Fonction : Auteur

Résumé

SummaryA 93 year-old woman with Paget's disease of bone had been treated with etidronate without interruption during 20 years. The daily dose was usual (5 mg/kg/day) but this prescription had never been stopped by her physicians. Two fractures had already occurred in pagetic (right tibia) and non pagetic bones (right fibula) within the last 2 years, and she presented rib fractures, another right tibia fracture and right femur fracture during hospitalization time. X-rays films showed major osteolysis of left ulna and right tibia. Blood samples and technetium bone scan brought no evidence for sarcoma or lytic evolution of the disease. A transiliac bone biopsy on non pagetic bone site confirmed the diagnosis of osteomalacia (increased osteoid parameters), with secondary hyperparathyroidism (hook resorption). In Paget's disease of bone, continuous treatment by etidronate may induce generalized osteomalacia, and increase the risk of fracture in both pagetic and non-pagetic bones. Whereas physicians and pharmaceutical industry try to improve the observance of those drugs, this striking observation also points out that a prescription always needs to be updated.

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Dates et versions

hal-03262103 , version 1 (16-06-2021)

Identifiants

Citer

Emmanuel Hoppé, Charles Masson, A. Laffitte, Daniel Chappard, Maurice Audran. Osteomalacia in a patient with Paget's bone disease treated with long-term etidronate. Morphologie, 2012, 96 (313), pp.40 - 43. ⟨10.1016/j.morpho.2012.08.001⟩. ⟨hal-03262103⟩

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