Systemic mastocytosis and bone involvement in a cohort of 75 patients. Issue 10 (22nd June 2010)

• Record Type: Journal Article
• Authors: Barete, S; Assous, N; de Gennes, C; Grandpeix, C; Feger, F; Palmerini, F; Dubreuil, P; Arock, M; Roux, C; Launay, J M; Fraitag, S; Canioni, D; Billemont, B; Suarez, F; Lanternier, F; Lortholary, O; Hermine, O; Francès, C
• Is Part Of: Annals of the rheumatic diseases. Volume 69:Issue 10(2010)
• Page Start: 1838
• Page End: 1841
• Publication Date: 2010-06-22
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/ard.2009.124511
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objectives: To investigate bone involvement in a large cohort of systemic mastocytosis (SM) patients, and evaluate the efficacy of bisphosphonate therapy. Patients and Methods: From 2000 to 2004, 75 patients with SM according to WHO criteria underwent skeletal x-rays and bone mineral density (BMD) assessment. Sequential BMD assessments were performed in nine patients treated with bisphosphonate (mean follow-up 65 months). Results: 37 patients (49%) had bone involvement according to both x-rays and BMD evaluations: osteoporosis (23 patients, 31%, mean lumbar spine T score: −3 SD), with vertebral fracture (13 patients, 17%), axial skeleton osteosclerosis (six patients, 8%), mixed patterns (three patients), osteopenia with pre-existing fractures (four patients) and focal osteolytic lesion (one patient). Blood count abnormalities were associated with osteosclerosis (p=0.005). In nine patients with osteoporosis and bisphosphonate therapy, mean lumbar spine BMD increased from 0.83 to 0.92 g/cm 2 (+11.1%; ie, +2.05% per year) without recurrence of vertebral fracture. Conclusion: Half of adult patients with SM have bone involvement. Osteoporosis is the most prevalent bone manifestation in SM (31%). Bisphosphonate therapy seems efficient to improve lumbar spine BMD during SM-related osteoporosis. Spine x-ray and BMD should be performed in all SM patients to detect those who may benefit from anti-osteoporotic therapy.