A Bone Histomorphometric Analysis of Hypophosphatasia-related Osteoporosis after Teriparatide Treatment

A 79-year-old man was admitted with a compression fracture of the first lumbar vertebra. His alkaline phosphatase (ALP) level was 35 IU/L, and his dual energy X-ray absorptiometry T score was -3.7 standard deviations, indicating osteoporosis. A genetic analysis showed a mutation of the alkaline phos...

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Autores principales: Mizuno, Hiroki, Sawa, Naoki, Sekine, Akinari, Inoue, Noriko, Oba, Yuki, Ikuma, Daisuke, Yamanouchi, Masayuki, Hasegawa, Eiko, Suwabe, Tatsuya, Suzuki, Hisanori, Hoshino, Junichi, Ubara, Yoshifumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2022
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9876712/
https://www.ncbi.nlm.nih.gov/pubmed/35650135
http://dx.doi.org/10.2169/internalmedicine.9624-22
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author Mizuno, Hiroki
Sawa, Naoki
Sekine, Akinari
Inoue, Noriko
Oba, Yuki
Ikuma, Daisuke
Yamanouchi, Masayuki
Hasegawa, Eiko
Suwabe, Tatsuya
Suzuki, Hisanori
Hoshino, Junichi
Ubara, Yoshifumi
author_facet Mizuno, Hiroki
Sawa, Naoki
Sekine, Akinari
Inoue, Noriko
Oba, Yuki
Ikuma, Daisuke
Yamanouchi, Masayuki
Hasegawa, Eiko
Suwabe, Tatsuya
Suzuki, Hisanori
Hoshino, Junichi
Ubara, Yoshifumi
author_sort Mizuno, Hiroki
collection PubMed
description A 79-year-old man was admitted with a compression fracture of the first lumbar vertebra. His alkaline phosphatase (ALP) level was 35 IU/L, and his dual energy X-ray absorptiometry T score was -3.7 standard deviations, indicating osteoporosis. A genetic analysis showed a mutation of the alkaline phosphatase biomineralization-associated gene encoding tissue-nonspecific alkaline phosphatase. Hypophosphatasia-related osteoporosis was diagnosed. Alendronate, teriparatide, and minodronate were administered in that order. The ALP level increased during teriparatide use. A bone biopsy performed after three years of teriparatide treatment showed that cancellous bone was adynamic. In cortical bone, tetracycline double-labeling indicates enhanced bone formation. Teriparatide may thus be a viable treatment option even in patients with hypophosphatasia.
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spelling pubmed-98767122023-02-02 A Bone Histomorphometric Analysis of Hypophosphatasia-related Osteoporosis after Teriparatide Treatment Mizuno, Hiroki Sawa, Naoki Sekine, Akinari Inoue, Noriko Oba, Yuki Ikuma, Daisuke Yamanouchi, Masayuki Hasegawa, Eiko Suwabe, Tatsuya Suzuki, Hisanori Hoshino, Junichi Ubara, Yoshifumi Intern Med Case Report A 79-year-old man was admitted with a compression fracture of the first lumbar vertebra. His alkaline phosphatase (ALP) level was 35 IU/L, and his dual energy X-ray absorptiometry T score was -3.7 standard deviations, indicating osteoporosis. A genetic analysis showed a mutation of the alkaline phosphatase biomineralization-associated gene encoding tissue-nonspecific alkaline phosphatase. Hypophosphatasia-related osteoporosis was diagnosed. Alendronate, teriparatide, and minodronate were administered in that order. The ALP level increased during teriparatide use. A bone biopsy performed after three years of teriparatide treatment showed that cancellous bone was adynamic. In cortical bone, tetracycline double-labeling indicates enhanced bone formation. Teriparatide may thus be a viable treatment option even in patients with hypophosphatasia. The Japanese Society of Internal Medicine 2022-05-31 2023-01-01 /pmc/articles/PMC9876712/ /pubmed/35650135 http://dx.doi.org/10.2169/internalmedicine.9624-22 Text en Copyright © 2023 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Mizuno, Hiroki
Sawa, Naoki
Sekine, Akinari
Inoue, Noriko
Oba, Yuki
Ikuma, Daisuke
Yamanouchi, Masayuki
Hasegawa, Eiko
Suwabe, Tatsuya
Suzuki, Hisanori
Hoshino, Junichi
Ubara, Yoshifumi
A Bone Histomorphometric Analysis of Hypophosphatasia-related Osteoporosis after Teriparatide Treatment
title A Bone Histomorphometric Analysis of Hypophosphatasia-related Osteoporosis after Teriparatide Treatment
title_full A Bone Histomorphometric Analysis of Hypophosphatasia-related Osteoporosis after Teriparatide Treatment
title_fullStr A Bone Histomorphometric Analysis of Hypophosphatasia-related Osteoporosis after Teriparatide Treatment
title_full_unstemmed A Bone Histomorphometric Analysis of Hypophosphatasia-related Osteoporosis after Teriparatide Treatment
title_short A Bone Histomorphometric Analysis of Hypophosphatasia-related Osteoporosis after Teriparatide Treatment
title_sort bone histomorphometric analysis of hypophosphatasia-related osteoporosis after teriparatide treatment
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9876712/
https://www.ncbi.nlm.nih.gov/pubmed/35650135
http://dx.doi.org/10.2169/internalmedicine.9624-22
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