Acromegaly and proximal femoral fracture in an aged person: bone histomorphometry, vitamin D metabolites and parathormone.
Osteoporosis and fractures are rare in acromegaly. An 84-year-old acromegalic woman sustained a fractured neck of femur in a fall. Histomorphometric analysis of an iliac crest biopsy showed marked osteoporosis and augmented resorption parameters. Cortical plates were very thin and bone volume was 8.5%; 12.5% is the reference value for women at this age. The total resorption surfaces were 23.7% compared with the reference value of 8%. We conjecture that postmenopausal and involutional osteoporosis were far advanced before the development of acromegaly, explaining the coexistence of the two conditions. Parathormone (65 pmol/l) and 24,25-dihydroxyvitamin D (1.34 ng/ml) levels were within normal limits, but those of 25-hydroxyvitamin D (5.6 ng/ml) and 1,25-dihydroxyvitamin D (15 pg/ml) were markedly decreased.
Lowenthal
M N
MN
Department of Geriatric Medicine, Soroka Medical Center, Beer Sheva, Israel.
Galinsky
D
D
Fried
V
V
Castel
H
H
Shany
S
S
Gazit
D
D
D000172:Acromegaly / Q000150:complications*; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001862:Bone Resorption / Q000473:pathology; D002117:Calcitriol / Q000097:blood; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications*; D006801:Humans; D006887:Hydroxycholecalciferols / Q000097:blood; D007085:Ilium / Q000473:pathology; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000150:complications / Q000473:pathology; D010281:Parathyroid Hormone / Q000097:blood*; D014807:Vitamin D / Q000097:blood*
D006887:Hydroxycholecalciferols; D010281:Parathyroid Hormone; D014807:Vitamin D; D002117:Calcitriol