Epidemiological, clinical, and genetic characteristics of Paget's disease of bone in a rural area of Calabria, Southern Italy.
BACKGROUND
The prevalence of Paget's disease of bone (PDB) is unknown in peninsular Southern Italy, although an elevated clinical severity of the disease was reported in patients from Campania.


OBJECTIVE
This study was performed to evaluate the epidemiological and genetic characteristics of PDB in a rural area of Calabria, the southernmost region in the Italian peninsula.


METHODS
We examined 1068 consecutive pelvic radiographs of patients older than 40 yr referred for any reason to the "Spinelli" Hospital, Belvedere Marittimo, from January 1st 2004 to December 31st 2006. In subjects with radiological findings of pelvic PDB, a 99m Technetium methylene diphosphonate bone scan and the sequence analysis of the sequestosome 1 (SQSTM1) gene were subsequently performed.


RESULTS
In the examined geographic area, the crude radiographic prevalence of pelvic PDB was 0.74% (8/1068; male:female 5:3, mean age 71.6 ± 13.1 yr) whereas the estimated overall prevalence of PDB between 0.82% and 1.21%. PDB patients from Calabria showed clinical characteristics similar to those reported in patients from Campania. The disease was also frequently complicated by osteoarthritis and the right side of the body was more affected than the left. The SQSTM1 gene analysis revealed the presence of a novel missense mutation (M401V) in exon 8 in one subject with a familial and aggressive form of PDB.


CONCLUSIONS
The study results confirmed that patients with PDB from rural districts of Southern Italy show an earlier onset and an increased clinical severity of the disease that appears mostly independent from the presence of germinal SQSTM1 mutations.
Rendina
D
D
Department of Clinical and Experimental Medicine, Federico II University Medical School, via S. Pansini, 5 - 80131 Naples, Italy.
Gianfrancesco
F
F
De Filippo
G
G
Merlotti
D
D
Esposito
T
T
Aloia
A
A
Benvenuto
D
D
Vivona
C L
CL
Annunziata
G
G
Nuti
R
R
Strazzullo
P
P
Mossetti
G
G
Gennari
L
L
D048868:Adaptor Proteins, Signal Transducing / Q000235:genetics*; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001842:Bone and Bones / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010001:Osteitis Deformans / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000235:genetics*; D015995:Prevalence; D011859:Radiography; D011877:Radionuclide Imaging; D000071456:Sequestosome-1 Protein; D013669:Technetium Tc 99m Medronate
D048868:Adaptor Proteins, Signal Transducing; C099718:SQSTM1 protein, human; D000071456:Sequestosome-1 Protein; D013669:Technetium Tc 99m Medronate