Osteitis deformans

Pa.g et s Disease of Bone. Paget s disease, osteitis deformans, occurs mainly ia people over 40. About twice as many men as women are affected. The disease, caused by faulty utilisation of may be mild and asymptomatic requiring Httle or no treatment. Clinical signs are high alkaline phosphatase and high urine hydroxyproline as weU as abnormal bone stmcture which usually goes unrecognised until discovered accidentally by routine x-ray examination (32). 

The answer is c. (Hardman, pp 1536-1537.) Calcitonin is useful in the therapy of Paget s disease of bone (osteitis deformans) Calcitonin ther-... 

Using the Bodansky (B18, 52) procedure with 8-glycerophosphate as substrate, Woodard (W8) was unable to obtain such elevations. She determined the serum acid phosphatase activities in 83 females and 342 males, or a total of 425 patients with miscellaneous diseases. Of these, 61 had various types of infectious or metabolic disorders, including 11 cases of inflammatory disease of bone and 12 cases of hepatic cirrhosis. The remainder had some type of neoplastic disease and about one-third had metastases to bone from cancer of various primary sites. There were 15 cases of osteogenic sarcoma and 32 cases of osteitis deformans. All these cases, whether their serum alkaline phosphatase activities were elevated or not, had serum acid phosphatase values that were essentially within the normal range, 0.06-0.89 Bodansky unit for females and 0.11-0.88 unit for males. In contrast to the Gutman method (GIO, G14), there-... 

Calcitonin is used in the treatment of Paget s disease (osteitis deformans), a chronic disorder characterized by increased bone remodeling, normocalcemia and normophosphatemia, frequent episodes of hypercalciuria leading to stone formation, and elevation of serum alkaline phosphatase and urinary hydroxyproline levels. The disease does not appear to be primarily a derangement of calcium metabolism. Calcitonin reduces the levels of serum alkaline phosphatase and urinary hydroxyproline, and may relieve other symptoms of the disease as well. Diphosphonates, especially etidronate disodium, also reduce bone resorption in this disease. Various cancers are accompanied by hypercalcemia and may respond to treatment with calcitonin. 

Bone conditions Elevated levels are found in those bone diseases which have increased osteoblastic activity, the highest levels being found in bone cancers and in Paget s disease (osteitis deformans). Moderate increases are found in osteomalacia, rickets and primary and secondary hyperparathyroidism. The raised serum alkaline phosphatase of normal children is due to increased osteoblastic activity. 

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