RESUMO
In South America the incidence of Paget's disease of bone (PDB) is low and more than half of the cases published in the last 30 years come from Brazil and Argentina. The aim of this study was to describe the clinical and epidemiological characteristics of PDB in two institutions in Pernambuco. PDB patients in Recife, Brazil were studied retrospectively. A total of 108 cases were diagnosed from 1984 to 2005. Over 90% of the patients were of European descent. The average age was 66.2 years and 49.1% were male. The polyostotic form was the more common. Pain and bone deformity were significantly more frequent in this group and in the total group. Clear eyes were observed in 22.2% of the patients and 23.1% had a family history record of PDB. The most frequently affected bones were the pelvis, lumbar vertebrae, femurs, and skull. Zoledronate was the most effective drug in reducing the alkaline phosphatase. Our data show that PDB in Recife occurs predominantly among those of European descents, usually in the polyostotic presentation, thus providing evidence of genetic and historical factors in the prevalence of PDB in that region.
Assuntos
Osteíte Deformante/diagnóstico , Osteíte Deformante/epidemiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteíte Deformante/etnologia , Estudos Retrospectivos , Distribuição por Sexo , População BrancaRESUMO
BACKGROUND: Paget disease of bone (PD) is a localized disorder of bone remodeling, which leads to bone fragility and deformity. In Chile PD is uncommon. AIM: To study clinical and demographic characteristics of patients with PD seen in the Clinical Hospital of the Catholic University. PATIENTS AND METHODS: Patients with typical radiological and clinical features of PD referred to our institution during the last decade were included in this review. RESULTS: We obtained data from 15 patients with PD (ten males, eight Chilean, six European and one Asian), eleven of them were diagnosed during the last 3 years. The mean age at diagnosis was 68.7 +/- 11.1 years old. No one had first degree relatives with PD. Bone pain was the main complaint in 13 patients and elevated total alkaline phosphatases in the other two. The average duration of the symptoms prior to diagnosis was 38.8 months. Eight patients had monostotic lesions; the most commonly involved sites were the pelvis, spine and femur. Radiological evaluation disclosed sclerotic changes in all patients as well as bone deformity and osteoarthritis in eight patients. Total alkaline phosphatases were elevated in 14 cases (mean: 4 times over the upper normal limit). CONCLUSIONS: When compared to series of the Northern hemisphere, PD in Chile is characterized by an older age at diagnosis, a higher frequency of symptomatic presentation, advanced radiological involvement and greater proportion of complications. PD should be suspected in every patient, Chilean or foreigner, with bone pain or elevated alkaline phosphatases.
Assuntos
Fosfatase Alcalina/sangue , Osteíte Deformante/diagnóstico , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Chile/epidemiologia , Europa (Continente)/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteíte Deformante/complicações , Osteíte Deformante/etnologiaRESUMO
BACKGROUND: Paget disease of bone (PD) is a localized disorder of bone remodeling, which leads to bone fragility and deformity. In Chile PD is uncommon. AIM: To study clinical and demographic characteristics of patients with PD seen in the Clinical Hospital of the Catholic University. PATIENTS AND METHODS: Patients with typical radiological and clinical features of PD referred to our institution during the last decade were included in this review. RESULTS: We obtained data from 15 patients with PD (ten males, eight Chilean, six European and one Asian), eleven of them were diagnosed during the last 3 years. The mean age at diagnosis was 68.7 +/- 11.1 years old. No one had first degree relatives with PD. Bone pain was the main complaint in 13 patients and elevated total alkaline phosphatases in the other two. The average duration of the symptoms prior to diagnosis was 38.8 months. Eight patients had monostotic lesions; the most commonly involved sites were the pelvis, spine and femur. Radiological evaluation disclosed sclerotic changes in all patients as well as bone deformity and osteoarthritis in eight patients. Total alkaline phosphatases were elevated in 14 cases (mean: 4 times over the upper normal limit). CONCLUSIONS: When compared to series of the Northern hemisphere, PD in Chile is characterized by an older age at diagnosis, a higher frequency of symptomatic presentation, advanced radiological involvement and greater proportion of complications. PD should be suspected in every patient, Chilean or foreigner, with bone pain or elevated alkaline phosphatases.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Fosfatase Alcalina/sangue , Osteíte Deformante/diagnóstico , Chile/epidemiologia , Europa (Continente)/etnologia , Idade de Início , Osteíte Deformante/complicações , Osteíte Deformante/etnologiaRESUMO
Paget's bone disease is heterogeneously distributed and several foci of high prevalence have been reported in Europe, United States, Argentina and Australia. The aim of the present work was to determine the ethnic origin of the disease in Buenos Aires using a cross sectional epidemiological study. Sample choice was based on a sampling according to grandparents' nationality. Ninety five percent of Paget patients were of European descent and 5% were non-European, while in the control group the proportion of European descendants is lower: 83% (OR: 3.7; p < 0.007; IC 95%: 1.4-9.7). Within the group of patients with Paget's disease the proportion of Italian and Russian descendants was higher than expected according to the 1914 Argentinean census. The prevalence of Paget's disease among European migrants was higher than in the control group of citizens. Regardless of environmental factors, it is likely that the migrants carried a higher risk of developing the disease.
Assuntos
Osteíte Deformante/etnologia , Argentina/epidemiologia , Distribuição de Qui-Quadrado , Estudos Transversais , Europa (Continente)/etnologia , Feminino , Humanos , Masculino , Osteíte Deformante/epidemiologia , PrevalênciaRESUMO
In a mainly retrospective but partly prospective survey of the period 1968-1993 in southern Israel, 61 cases of Paget's disease of bone were identified. Fifty six percent were of non-Afro-Asian origin and 44% originated from Afro-Asia, which is approximately the inverse of the ratio in the local general population. The largest single groups from non-Afro-Asia and Afro-Asia originated, from Romania and Tunisia, respectively, and Australia and Argentina were also disproportionately prominent as countries of origin. Israel itself was the origin of few patients. All the patients were Jews except for one Bedouin Arab, which is far different from the distribution of Bedouins and Jews in both the surveyed area and the hospital population. The differences between these groups numerically and against the background local population may well have been statistically significant had the circumstances enabled greater randomness in the collection of the data analyzed. It is surmised that in southern Israel the prevalence of Paget's disease of bone is about 1%, similar to that in southern Europe.