title: Torg-Winchester syndrome: lack of efficacy of pamidronate therapy.
abstract: Torg-Winchester syndrome, which includes nodular arthropathy with osteolysis (OMIM 605156), is a condition associated with generalized osteoporosis. On the basis of usefulness of pamidronate in conditions with osteoporosis, we hypothesized that the drug will improve osteolysis and/or osteoporosis in this condition. After obtaining informed consent from the parents, two siblings affected with Torg-Winchester syndrome were administered intravenous pamidronate over a period of 3 years. The clinical status was monitored along with the bone mineral density (using radiographs and X-ray densitometry) to assess the effect of the drug. Clinically there was no improvement. Although the bone mineral density improved in axial skeleton, osteoporosis and osteolysis continued to worsen in the appendicular skeleton. We conclude that pamidronate does not improve peripheral osteolysis in multicentric osteolysis and nodular arthropathy caused by mutation in matrix metalloproteinase 2 gene.
authors.affiliation: Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India Department of Human Genetics, Mount Sinai School of Medicine, New York, USA.
authors.forename: Shubha R
authors.initials: SR
authors.lastname: Phadke
authors.forename: Maria
authors.initials: M
authors.lastname: Ramirez
authors.forename: Analisa
authors.initials: A
authors.lastname: DiFeo
authors.forename: John A
authors.initials: JA
authors.lastname: Martignetti
authors.forename: Katta M
authors.initials: KM
authors.lastname: Girisha
mesh_terms: D000015:Abnormalities, Multiple / Q000188:drug therapy*; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001848:Bone Diseases, Developmental / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006226:Hand Deformities / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D000077268:Pamidronate; D011859:Radiography; D013577:Syndrome; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077268:Pamidronate