PAGET'S DISEASE OF BONE

Paget's Disease Of Bone



Paget's Disease Of Bone

Introduction

Paget's disease of bone causes your bones to grow larger and weaker than normal. They also might break easily. The disease can lead to other health problems, too, such as arthritis and hearing loss (Barker 2004). You can have Paget's disease in any bone, but it is most common in the spine, pelvis, skull and legs. The disease might affect one or several bones, but not your entire skeleton. More men than women have the disease. It is most common in older people.

Discussion

Paget's disease of bone is a condition affecting how your bone breaks down and rebuilds (Staa 2002). Healthy bone metabolism allows for old bone to be recycled into new bone throughout your life.

In Paget's disease of bone, the rate at which old bone is broken down and new bone is formed is distorted. Over time, Paget's disease of bone may result in your bones becoming fragile and misshapen.

Paget's disease of bone is more common with age. Many older people with discomfort in their bones and joints assume the discomfort is a natural part of aging, and don't seek treatment. But to prevent the most serious complications of Paget's disease of bone, it's important to get treatment as soon as possible after symptoms appear (Tiegs 2000).

Aetiology

Paget's disease of bone is a common bone disease characterized by increased and disorganized bone remodelling at focal sites throughout the skeleton. The aetiology of the disease is unresolved (Sissons 2006). A persistent viral infection has long been suggested to cause the disease. Antigen and/or nucleic acid sequences of paramyxoviruses (in particular measles virus [MV], canine distemper virus [CDV], and respiratory syncytial virus [RSV]) have been reported in pagetic bone by a number of groups; however, others have been unable to confirm this and so far no virus has been isolated from patients. Here, we re-examined the question of viral involvement in Paget's disease in a study involving 53 patients with established disease recruited from seven centres throughout the United Kingdom (Siris 2006). Thirty-seven patients showed clear signs of active disease by bone scan and/or histological assessment of the bone biopsy specimens and 12 of these had not received any therapy before samples were taken.

Presence of paramyxovirus nucleic acid sequences was sought in bone biopsy specimens, bone marrow, or peripheral blood mononuclear cells using reverse-transcription polymerase chain reaction (RT-PCR) with a total of 18 primer sets (7 of which were nested), including 10 primer sets (including 3 nested sets) specifically for MV or CDV. For each patient at least one sample was tested with all primer sets by RT-PCR and no evidence for the presence of paramyxovirus RNA was found in any patient. In 6 patients, bone biopsy specimens with clear histological evidence of active disease tested negative for presence of measles and CDV using immunocytochemistry (ICC) and in situ hybridization (ISH) (Kanis 2001). Intranuclear inclusion bodies, similar to those described by others previously, were seen in pagetic ...