Paget’s Disease of Bone in Patients under 40 Years

Paget’s disease of bone (PDB) is a focal disorder of accelerated skeletal remodelling that is uncommon in patients under the age of 40 years; it is more prevalent in older individuals. We report two cases of PDB diagnosed in early adulthood at the Mohamed Kassab Institute of Orthopedics, La Manouba, Tunisia. The first case was a 35-year-old male patient who presented in 2011 with a seven-month history of hip pain. The second case was a 39-year-old female patient who presented 2014 with chronic lower back pain. The PDB diagnosis was confirmed with clinical, biological and radiological investigations. Both patients were doing well on follow-up. Some previous cases have been reported in the literature, differing from the presented cases in some aspects; data of PDB features at differing ages is still insufficient. Early recognition of this clinical entity in young patients is important as early treatment can affect the progression of the disease.

[1]  Z. Sheng,et al.  Clinical features, diagnosis and treatment of Paget’s disease of bone in mainland China: A systematic review , 2020, Reviews in Endocrine and Metabolic Disorders.

[2]  Vivek Javagal,et al.  A rare incident of Paget's disease of bone in early adult life , 2014, Journal of oral and maxillofacial pathology : JOMFP.

[3]  A. Zati,et al.  Degeneration of Paget’s disease into sarcoma: clinical and therapeutic influencing factors , 2008, La Chirurgia degli organi di movimento.

[4]  M. Zillikens,et al.  [A young woman with headaches and skull anomalies: a long road to the diagnosis 'Paget's disease']. , 2006, Nederlands tijdschrift voor geneeskunde.

[5]  A. Olivé,et al.  Paget’s disease of bone in early adult life , 2005, Annals of the rheumatic diseases.

[6]  M. Murphey,et al.  Paget’s Disease of Bone in Patients Younger Than 40 Years , 2004, Clinical orthopaedics and related research.

[7]  E. Collantes Estévez,et al.  [Bone Paget's disease in the young adult]. , 2004, Revista clinica espanola.

[8]  E. Siris,et al.  A Clinical Approach to Diagnosis and Management of Paget's Disease of Bone , 2001, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[9]  W. Winkelmann,et al.  The bisphosphonate pamidronate is a potent inhibitor of human osteosarcoma cell growth in vitro , 2001, Anti-cancer drugs.

[10]  J. Kanis,et al.  Atypical familial Paget's disease of bone. , 2001, Joint, bone, spine : revue du rhumatisme.

[11]  P. Choong,et al.  Bisphosphonates regulate cell growth and gene expression in the UMR 106-01 clonal rat osteosarcoma cell line , 2001, British Journal of Cancer.

[12]  W. Reinus,et al.  Paget Bone Disease Involving Young Adults in 3 Generations of a Korean Family , 1997, Medicine.

[13]  P. Delmas,et al.  MANAGEMENT OF PAGET’S DISEASE OF BONE , 1978 .

[14]  M. Audran,et al.  Progression in length and width of pagetic lesions, and estimation of age at disease onset. , 1997, Revue du rhumatisme.

[15]  G. López-Abente,et al.  Frequency and characteristics of familial aggregation of paget's disease of bone , 1995, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[16]  K. Kumar Paget's disease of bone. , 1986, Calcified tissue international.

[17]  P. Bannister,et al.  Recurrent hypercalcaemia in a young man with mono-ostotic Paget's disease. , 1986, Postgraduate medical journal.

[18]  W. Murphy,et al.  Osteolytic Paget's bone disease in a young man. Rapid healing with human calcitonin therapy. , 1985, The American journal of medicine.

[19]  S. Mcloughlin,et al.  Pathological fracture of the humerus in a young adult with Paget's disease of bone. , 1984, Injury.

[20]  C. P. Schwinn,et al.  Osteogenic sarcoma arising in Paget's disease , 1964, Cancer.

[21]  I. Miner Sarcoma in Paget's disease of bone. , 1950, Bulletin of the Hospital for Joint Diseases.