High prevalence of fractures and osteoporosis in patients with indolent systemic mastocytosis
- 9 January 2012
- Vol. 67 (3), 431-438
- https://doi.org/10.1111/j.1398-9995.2011.02780.x
Abstract
Background: Indolent systemic mastocytosis (ISM) is a rare disease characterized by accumulation of abnormal mast cells in various tissues, including bone marrow. Symptoms are usually related to release of mast cell mediators. The aims are to establish the prevalence of osteoporotic fractures in ISM and to investigate the association with serum tryptase and the urinary histamine metabolites, methylhistamine (MH), and methylimidazole acetic acid. Methods: The fracture prevalence in 157 patients (65 men; 92 women), mean age 54 ± 12 years, was assessed by vertebral morphometry and data from patient records, supplemented by a questionnaire. Bone mineral density (BMD) of lumbar spine and femoral neck was measured, and tryptase and histamine metabolites were analysed. Results: We registered 235 lifetime fractures in 154 patients, including 140 osteoporotic (low-energy trauma) fractures, of which 62% were vertebral, 1% hip and 36% other nonvertebral fractures. Osteoporotic fractures and osteoporosis were found in 37% and 28% of the patients, respectively. In men, the prevalence of these osteoporotic manifestations (46% <50 years; 73% ≥50 years) was much higher compared with women (18% <50 years; 58% ≥50 years). Older age, male gender, and higher urinary MH were independently related to the osteoporotic manifestations. Conclusions: This first publication about prevalence of fractures and osteoporosis in patients with ISM shows that the risk of osteoporotic fractures is high, especially in men. Higher urinary MH levels are associated with a higher risk of osteoporotic manifestations. Routine measurements of BMD and vertebral morphometry are warranted in these patients for early detection of osteoporosis.Keywords
This publication has 35 references indexed in Scilit:
- Mast cells and inflammationBiochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, 2012
- Bone mineral density, bone turnover markers and fractures in patients with indolent systemic mastocytosisBone, 2011
- Epidemiology of fractures in children and adolescentsActa Orthopaedica, 2010
- Human mast cells express androgen receptors but treatment with testosterone exerts no influence on IgE‐independent mast cell degranulation elicited by neuromuscular blocking agentsExperimental Dermatology, 2010
- Biochemical markers predictive for bone marrow involvement in systemic mastocytosisHaematologica, 2008
- IL-6 levels predict disease variant and extent of organ involvement in patients with mastocytosisClinical Immunology, 2005
- Long‐term follow‐up of indolent mastocytosis in adultsJournal of Internal Medicine, 1996
- Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO reportOsteoporosis International, 1994
- Vertebral fracture assessment using a semiquantitative techniqueJournal of Bone and Mineral Research, 1993
- Systemic Mast Cell DiseaseMedicine, 1988