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Paget's disease of bone.
J Bone Miner Res. 1998 Jul; 13(7):1061-5.JB

Abstract

Paget's disease of bone is a localized disorder of bone remodeling. Increased numbers of larger than normal osteoclasts initiate the process at affected skeletal sites, and the increase in bone resorption is followed by an increase in new bone formation, altering bone architecture. The signs and symptoms of Paget's disease are varied, depending in part on the location of the involved sites and the degree of increased bone turnover. Recent progress in Paget's disease research includes new data regarding the etiology of this disorder and the ongoing development of more effective therapies. Although the cause of Paget's disease remains unproven, the creation of pagetic osteoclasts seems ever more likely to result from both genetic and environmental factors. Many studies indicate that in patients with Paget's disease, both osteoclasts and their precursors harbor evidence of a paramyxovirus infection, although not all studies confirm this finding. Very recent genetic investigations have identified one candidate gene on chromosome 18q, although genetic heterogeneity is almost certainly present. Advances in treatment have resulted from the availability of several potent bisphosphonate compounds (e.g., pamidronate, alendronate, and risedronate) that, unlike earlier treatments, produce normal or near normal bone turnover indices in a majority of patients. New bone formation after such treatment has a more normal, lamellar pattern, and mineralization abnormalities are rare to absent with the newer compounds. The availability of such agents has prompted a more aggressive management philosophy in which both symptomatic disease and also asymptomatic disease at sites with a risk of progression and future complications are viewed as clear indications for pharmacologic intervention.

Authors+Show Affiliations

Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

9661069

Citation

Siris, E S.. "Paget's Disease of Bone." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 13, no. 7, 1998, pp. 1061-5.
Siris ES. Paget's disease of bone. J Bone Miner Res. 1998;13(7):1061-5.
Siris, E. S. (1998). Paget's disease of bone. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 13(7), 1061-5.
Siris ES. Paget's Disease of Bone. J Bone Miner Res. 1998;13(7):1061-5. PubMed PMID: 9661069.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Paget's disease of bone. A1 - Siris,E S, PY - 1998/7/14/pubmed PY - 1998/7/14/medline PY - 1998/7/14/entrez SP - 1061 EP - 5 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J Bone Miner Res VL - 13 IS - 7 N2 - Paget's disease of bone is a localized disorder of bone remodeling. Increased numbers of larger than normal osteoclasts initiate the process at affected skeletal sites, and the increase in bone resorption is followed by an increase in new bone formation, altering bone architecture. The signs and symptoms of Paget's disease are varied, depending in part on the location of the involved sites and the degree of increased bone turnover. Recent progress in Paget's disease research includes new data regarding the etiology of this disorder and the ongoing development of more effective therapies. Although the cause of Paget's disease remains unproven, the creation of pagetic osteoclasts seems ever more likely to result from both genetic and environmental factors. Many studies indicate that in patients with Paget's disease, both osteoclasts and their precursors harbor evidence of a paramyxovirus infection, although not all studies confirm this finding. Very recent genetic investigations have identified one candidate gene on chromosome 18q, although genetic heterogeneity is almost certainly present. Advances in treatment have resulted from the availability of several potent bisphosphonate compounds (e.g., pamidronate, alendronate, and risedronate) that, unlike earlier treatments, produce normal or near normal bone turnover indices in a majority of patients. New bone formation after such treatment has a more normal, lamellar pattern, and mineralization abnormalities are rare to absent with the newer compounds. The availability of such agents has prompted a more aggressive management philosophy in which both symptomatic disease and also asymptomatic disease at sites with a risk of progression and future complications are viewed as clear indications for pharmacologic intervention. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/9661069/Paget's_disease_of_bone_ L2 - https://doi.org/10.1359/jbmr.1998.13.7.1061 DB - PRIME DP - Unbound Medicine ER -