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Brown Tumour in Chronic Kidney Disease: Revisiting an Old Disease with a New Perspective
SIMPLE SUMMARY: OFC (Osteitis Fibrosa Cystica) and Brown Tumours, skeletal lesions commonly found in chronic kidney disease (CKD) patients, are influenced by various risk factors, such as age, sex, medications affecting calcium metabolism, and vitamin D deficiency. The primary cause is secondary hyp...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452999/ https://www.ncbi.nlm.nih.gov/pubmed/37627135 http://dx.doi.org/10.3390/cancers15164107 |
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author | Santoso, Djoko Thaha, Mochammad Empitu, Maulana A. Kadariswantiningsih, Ika Nindya Suryantoro, Satriyo Dwi Haryati, Mutiara Rizki Hertanto, Decsa Medika Pramudya, Dana Bintoro, Siprianus Ugroseno Yudho Nasronudin, Nasronudin Alsagaff, Mochamad Yusuf Susilo, Hendri Wungu, Citrawati Dyah Kencono Budhiparama, Nicolaas C. Hogendoorn, Pancras C. W. |
author_facet | Santoso, Djoko Thaha, Mochammad Empitu, Maulana A. Kadariswantiningsih, Ika Nindya Suryantoro, Satriyo Dwi Haryati, Mutiara Rizki Hertanto, Decsa Medika Pramudya, Dana Bintoro, Siprianus Ugroseno Yudho Nasronudin, Nasronudin Alsagaff, Mochamad Yusuf Susilo, Hendri Wungu, Citrawati Dyah Kencono Budhiparama, Nicolaas C. Hogendoorn, Pancras C. W. |
author_sort | Santoso, Djoko |
collection | PubMed |
description | SIMPLE SUMMARY: OFC (Osteitis Fibrosa Cystica) and Brown Tumours, skeletal lesions commonly found in chronic kidney disease (CKD) patients, are influenced by various risk factors, such as age, sex, medications affecting calcium metabolism, and vitamin D deficiency. The primary cause is secondary hyperparathyroidism, leading to imbalances in calcium and phosphorus levels and osteoclast activation. Other factors, like RAAS hyperactivity and chronic inflammation, may also contribute to their development. The recently described involvement of KRAS mutations turned Brown Tumours from reactive lesions to potentially neoplastic lesions. To manage these conditions, pharmacologic treatments like bisphosphonates, calcimimetics, vitamin D supplementation, and denosumab can help by reducing hyperparathyroidism, restoring calcium levels, and preventing OFC occurrence. Brown Tumours, being rare, lack sufficient understanding regarding their manifestation and treatment. However, considering their impact on CKD patients’ quality of life, it is crucial for nephrologists and medical practitioners working with dialysis patients to be aware of various diagnostic and treatment options. ABSTRACT: Osteitis fibrosa cystica (OFC) and Brown Tumours are two related but distinct types of bone lesions that result from the overactivity of osteoclasts and are most often associated with chronic kidney disease (CKD). Despite their potential consequences, these conditions are poorly understood because of their rare prevalence and variability in their clinical manifestation. Canonically, OFC and Brown Tumours are caused by secondary hyperparathyroidism in CKD. Recent literature showed that multiple factors, such as hyperactivation of the renin–angiotensin–aldosterone system and chronic inflammation, may also contribute to the occurrence of these diseases through osteoclast activation. Moreover, hotspot KRAS mutations were identified in these lesions, placing them in the spectrum of RAS–MAPK-driven neoplasms, which were until recently thought to be reactive lesions. Some risk factors contributed to the occurrence of OFC and Brown Tumours, such as age, gender, comorbidities, and certain medications. The diagnosis of OFC and Brown Tumours includes clinical symptoms involving chronic bone pain and laboratory findings of hyperparathyroidism. In radiological imaging, the X-ray and Computed tomography (CT) scan could show lytic or multi-lobular cystic alterations. Histologically, both lesions are characterized by clustered osteoclasts in a fibrotic hemorrhagic background. Based on the latest understanding of the mechanism of OFC, this review elaborates on the manifestation, diagnosis, and available therapies that can be leveraged to prevent the occurrence of OFC and Brown Tumours. |
format | Online Article Text |
id | pubmed-10452999 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-104529992023-08-26 Brown Tumour in Chronic Kidney Disease: Revisiting an Old Disease with a New Perspective Santoso, Djoko Thaha, Mochammad Empitu, Maulana A. Kadariswantiningsih, Ika Nindya Suryantoro, Satriyo Dwi Haryati, Mutiara Rizki Hertanto, Decsa Medika Pramudya, Dana Bintoro, Siprianus Ugroseno Yudho Nasronudin, Nasronudin Alsagaff, Mochamad Yusuf Susilo, Hendri Wungu, Citrawati Dyah Kencono Budhiparama, Nicolaas C. Hogendoorn, Pancras C. W. Cancers (Basel) Review SIMPLE SUMMARY: OFC (Osteitis Fibrosa Cystica) and Brown Tumours, skeletal lesions commonly found in chronic kidney disease (CKD) patients, are influenced by various risk factors, such as age, sex, medications affecting calcium metabolism, and vitamin D deficiency. The primary cause is secondary hyperparathyroidism, leading to imbalances in calcium and phosphorus levels and osteoclast activation. Other factors, like RAAS hyperactivity and chronic inflammation, may also contribute to their development. The recently described involvement of KRAS mutations turned Brown Tumours from reactive lesions to potentially neoplastic lesions. To manage these conditions, pharmacologic treatments like bisphosphonates, calcimimetics, vitamin D supplementation, and denosumab can help by reducing hyperparathyroidism, restoring calcium levels, and preventing OFC occurrence. Brown Tumours, being rare, lack sufficient understanding regarding their manifestation and treatment. However, considering their impact on CKD patients’ quality of life, it is crucial for nephrologists and medical practitioners working with dialysis patients to be aware of various diagnostic and treatment options. ABSTRACT: Osteitis fibrosa cystica (OFC) and Brown Tumours are two related but distinct types of bone lesions that result from the overactivity of osteoclasts and are most often associated with chronic kidney disease (CKD). Despite their potential consequences, these conditions are poorly understood because of their rare prevalence and variability in their clinical manifestation. Canonically, OFC and Brown Tumours are caused by secondary hyperparathyroidism in CKD. Recent literature showed that multiple factors, such as hyperactivation of the renin–angiotensin–aldosterone system and chronic inflammation, may also contribute to the occurrence of these diseases through osteoclast activation. Moreover, hotspot KRAS mutations were identified in these lesions, placing them in the spectrum of RAS–MAPK-driven neoplasms, which were until recently thought to be reactive lesions. Some risk factors contributed to the occurrence of OFC and Brown Tumours, such as age, gender, comorbidities, and certain medications. The diagnosis of OFC and Brown Tumours includes clinical symptoms involving chronic bone pain and laboratory findings of hyperparathyroidism. In radiological imaging, the X-ray and Computed tomography (CT) scan could show lytic or multi-lobular cystic alterations. Histologically, both lesions are characterized by clustered osteoclasts in a fibrotic hemorrhagic background. Based on the latest understanding of the mechanism of OFC, this review elaborates on the manifestation, diagnosis, and available therapies that can be leveraged to prevent the occurrence of OFC and Brown Tumours. MDPI 2023-08-15 /pmc/articles/PMC10452999/ /pubmed/37627135 http://dx.doi.org/10.3390/cancers15164107 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Santoso, Djoko Thaha, Mochammad Empitu, Maulana A. Kadariswantiningsih, Ika Nindya Suryantoro, Satriyo Dwi Haryati, Mutiara Rizki Hertanto, Decsa Medika Pramudya, Dana Bintoro, Siprianus Ugroseno Yudho Nasronudin, Nasronudin Alsagaff, Mochamad Yusuf Susilo, Hendri Wungu, Citrawati Dyah Kencono Budhiparama, Nicolaas C. Hogendoorn, Pancras C. W. Brown Tumour in Chronic Kidney Disease: Revisiting an Old Disease with a New Perspective |
title | Brown Tumour in Chronic Kidney Disease: Revisiting an Old Disease with a New Perspective |
title_full | Brown Tumour in Chronic Kidney Disease: Revisiting an Old Disease with a New Perspective |
title_fullStr | Brown Tumour in Chronic Kidney Disease: Revisiting an Old Disease with a New Perspective |
title_full_unstemmed | Brown Tumour in Chronic Kidney Disease: Revisiting an Old Disease with a New Perspective |
title_short | Brown Tumour in Chronic Kidney Disease: Revisiting an Old Disease with a New Perspective |
title_sort | brown tumour in chronic kidney disease: revisiting an old disease with a new perspective |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452999/ https://www.ncbi.nlm.nih.gov/pubmed/37627135 http://dx.doi.org/10.3390/cancers15164107 |
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