Paget's disease of bone: diagnosis and treatment update.
Paget's disease is a metabolic bone disease characterized by excessive bone resorption and formation due to activated osteoclasts. Although Paget's disease is a high bone turnover state, the excess bone that is formed lacks the structural stability of normal bone. Complications from Paget's disease include deformity, fracture, and pain. Although still unclear, both prevalence and severity of Paget's disease seem to be declining. Recent progress has focused on the environmental as well as genetic etiologies for this disease. Many studies indicate a role for viral infectious agents, whereas others point to a recently identified candidate gene on chromosome 18q. Therapy with bisphosphonate drugs is the treatment of choice. With newer and more powerful agents from this family now available, the majority of patients affected by Paget's disease can achieve sustained remission and avoid complications.
Noor
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Postdoctoral fellow, Metabolism Section, Department of Medicine, University of California, San Francisco and Department of Veterans Affairs Medical Center, San Francisco, CA, USA.
Shoback
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D002116:Calcitonin / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D010001:Osteitis Deformans / Q000175:diagnosis* / Q000188:drug therapy*; D010010:Osteoclasts / Q000378:metabolism; D011379:Prognosis; D012720:Severity of Illness Index; D016896:Treatment Outcome
D004164:Diphosphonates; D002116:Calcitonin