title: Does Paget's disease exist in India?: A series of 21 patients.
abstract: OBJECTIVE
  Paget's disease of bone has been described as a few case reports from India. The aim of the present study is to document the existence of Paget's disease (PD) in India.
  
  
  METHODS
  We describe demography, clinical manifestations, biochemical and radiological profile and the treatment outcome of 21 patients of PD.
  
  
  RESULTS
  Mean (+/-SD) age of these patients at presentation was 49.2 +/- 17.6 years and the male to female ratio was 2.5:1. Common clinical manifestations included backache, headache and bone pains. Others were fracture, joint pain, deafness, gait ataxia, visual impairment and difficulty in biting. Two patients presented with hydrocephalus and one had recurrent paraparesis. Fifteen (71.4%) patients had polyostotic and six (28.6%) had monoostotic Paget's disease. More commonly involved bones were skull and spine (61.9%) followed by pelvis (38.1%), femur (33.3%), tibia (9%) and ulna (9%). Mean (+/-SD) serum alkaline phosphatase at diagnosis was 1514 +/- 1168 IU/L and nine months after treatment with bisphosphonates decreased to 454 +/- 406 IU/ L(P<0.03).
  
  
  CONCLUSIONS
  This illustrates that Paget's disease does exist in India and a high index of suspicion is required to clinch the diagnosis.
authors.affiliation: Department of Endocrinology, PGIMER, Chandigarh.
authors.forename: S
authors.initials: S
authors.lastname: Bhadada
authors.forename: A
authors.initials: A
authors.lastname: Bhansali
authors.forename: A G
authors.initials: AG
authors.lastname: Unnikrishnan
authors.forename: R
authors.initials: R
authors.lastname: Khadgawat
authors.forename: S K
authors.initials: SK
authors.lastname: Singh
authors.forename: A
authors.initials: A
authors.lastname: Mithal
authors.forename: U N
authors.initials: UN
authors.lastname: Saikia
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001416:Back Pain / Q000209:etiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002648:Child; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006261:Headache / Q000209:etiology; D006306:Health Surveys; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010001:Osteitis Deformans / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D018570:Risk Assessment; D017678:Sex Distribution
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates