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Diagnosis and treatment of Paget´s disease of bone: update 2020

Česká verze

Authors: Zikán Vít
Authors place of work: Osteocentrum, III. interní klinika 1. LF UK a VFN v Praze
Published in the journal: Clinical Osteology 2020; 25(4): 189-200
Category: Doporučené postupy

Summary

Paget’s disease of bone is a progressive focal disorder of bone metabolism characterized by an accelerated rate of bone remodeling, resulting in overgrowth of bone at selected sites and impaired integrity of affected bone. The risk of developing Paget’s disease increases with age and its onset is typically after age 55. Both genetic and environmental causes are thought to contribute to its pathogenesis. The main clinical manifestations are pain, deformities and secondary consequences of bone overgrowth in affected areas, such as osteoarthritis or nerve impingement, although many patients are asymptomatic. Radionuclide bone scan, in addition to targeted radiographs, are recommended as a means of fully and accurately defining the extent of metabolically active disease. In most patients, the serum alkaline phosphatase is elevated. Patients with Paget’s disease who are symptomatic or at risk of complications should be treated with aminobisphosphonates. Zoledronic acid is recommended as first-line therapy producing sustained remissions in almost all patients.

Keywords:

diagnosis – Paget’s disease of bone –treatment – zoledronic acid

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