title: Longitudinal Evaluation of Bone Mineral Density and Bone Metabolism Markers in Patients with Indolent Systemic Mastocytosis Without Osteoporosis.
abstract: Systemic Mastocytosis has been long identified as a potential cause of osteoporosis; nevertheless, data regarding longitudinal variation of bone mineral density (BMD) in patients with indolent systemic mastocytosis (ISM) are missing . We studied BMD variation at lumbar spine and proximal hip after 30-month (±6 months) follow-up in a large cohort of patients (83) with ISM without osteoporosis, supplementated with vitamin D and/or calcium when needed. We also analyzed the correlation between variation of BMD, basal serum tryptase levels and bone turnover markers (BTM). Sixty-four percent of our population was male; mean age was 52.1 (±11.5) years. Vitamin D insufficiency (serum levels of 25-OH-vitamin D, 25OHD, lower than 75 nmol/L) was found in more than 70 % of patients. After a follow-up of 30 ± 6 months with only vitamin D (5000-7500 IU weekly of oral cholecalciferol) or calcium (500 mg/die) supplementation when needed, we observed 2.1 % increase in BMD at lumbar spine, with no significant changes at hip. At the end of follow-up, almost 60 % of patients showed 25OHD serum levels still lower than recommended, despite vitamin D supplementation. Reduction in BMD after follow-up significantly correlated with high C-telopeptide of type I collagen serum levels at the time of diagnosis. In patients with ISM without osteoporosis, a routinary BMD evaluation within a time <2 years is not justified, except in the presence of elevated BTM. In these patients, vitamin D supplementation is frequently needed.
authors.affiliation: Hematology Section, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Artuso
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy. cristian.caimmi@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Caimmi
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Tripi
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: O
authors.initials: O
authors.lastname: Viapiana
authors.affiliation: Hematology Section, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bonifacio
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Idolazzi
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Gavioli
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Gatti
authors.affiliation: Hematology Section, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Zanotti
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rossini
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology*; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D034721:Mastocytosis, Systemic / Q000378:metabolism*; D008875:Middle Aged; D010024:Osteoporosis / Q000378:metabolism; D014807:Vitamin D / Q000097:blood*
chemical_list: D015415:Biomarkers; D014807:Vitamin D; D002118:Calcium
keywords: Bone; Indolent systemic mastocytosis; Vitamin D