■Denosumab是一种抑制骨吸收的单克隆抗体,可用于治疗骨质疏松症,骨转移,骨巨细胞瘤.我们描述了一名患有颅骨有症状的Paget病的妇女,其头痛和颅骨的单骨疾病在接受denosumab合并低骨密度后得到改善。
■一名75岁的女性出现持续1个月的头痛。她有风湿性多肌痛病史,骨质减少,甲状腺功能减退,和胃食管反流病.她报告说,风湿性多肌痛患者每天服用泼尼松1至20毫克,持续1年,并在出现前1个月接受了60毫克的denosumab治疗骨量减少。钙,碱性磷酸酶,骨特异性碱性磷酸酶水平为8.2mg/dL(参考范围[RR],8.5-10.5mg/dL),132U/L(RR,40-129U/L),和17.8μg/L(RR,7-22.4μg/L),分别。颅骨X线检查显示硬化/骨肥大,溶血性病变,和骨骼的扩张,符合Paget骨病(PDB)。在初次演讲五个月后,她的头痛解决了,钙和碱性磷酸酶水平分别为9.7U/L和96U/L,分别。
■Denosumab中和核因子κB配体的受体激活剂。迄今为止,英文文献中报道了2例Denosumab成功用于不能耐受或不符合双膦酸盐治疗条件的PDB患者.此病例报告描述了接受denosumab治疗的PDB患者骨量减少,其PDB相关症状得到改善。
■尽管denosumab最初被批准用于治疗骨质疏松症,通过抑制核因子-κB配体的受体激活剂抑制骨吸收可能在PDB的治疗中潜在有效。
UNASSIGNED: Denosumab is a monoclonal antibody that inhibits bone resorption and is indicated for the treatment of osteoporosis, bone metastases, and giant cell tumor of bone. We describe a woman with symptomatic Paget disease of the skull whose headaches and monostotic disease of the skull improved after receiving denosumab for concomitant low bone density.
UNASSIGNED: A 75-year-old woman presented with unremitting headache of 1 month. She had a medical history of polymyalgia rheumatica, osteopenia, hypothyroidism, and gastroesophageal reflux disease. She reported taking prednisone 1 to 20 mg daily for polymyalgia rheumatica for 1 year and received a dose of denosumab 60 mg for osteopenia 1 month before presentation. The calcium, alkaline phosphatase, and bone-specific alkaline phosphatase levels were 8.2 mg/dL (reference range [RR], 8.5-10.5 mg/dL), 132 U/L (RR, 40-129 U/L), and 17.8 μg/L (RR, 7-22.4 μg/L), respectively. Skull radiography revealed sclerosis/hyperostosis, lytic lesions, and expansion of bone, consistent with Paget disease of bone (PDB). Five months after the initial presentation, her headache resolved, and her calcium and alkaline phosphatase levels were 9.7 U/L and 96 U/L, respectively.
UNASSIGNED: Denosumab neutralizes the receptor activator of nuclear factor-kappa B ligand. To date, there have been 2 case reports reported in the English literature of denosumab used successfully in patients with PDB who could not tolerate or were not eligible for bisphosphonates. This case report describes a patient with PDB treated with denosumab for osteopenia who experienced improvement in PDB-related symptoms.
UNASSIGNED: Although denosumab was originally approved for the treatment of osteoporosis, the inhibition of bone resorption via inhibition of the receptor activator of nuclear factor-kappa B ligand may be potentially effective in the treatment of PDB.