Hong Kong Med J 2013;19:242–8 | Number 3, June 2013 | Epub 3 Apr 2013
A case series of Paget's disease of bone in Chinese
Winnie ZM Wat, William SK Cheung, Tina WS Lau
Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
OBJECTIVE. To report a series of patients with Paget's disease of bone that is rarely diagnosed in the Chinese, and to describe their presentations and clinical characteristics.
DESIGN. A retrospective case series and literature review.
SETTING. A regional public hospital in Hong Kong.
PATIENTS. Patients with a diagnosis of Paget's disease of bone (or osteitis deformans) documented in the Clinical Management System of the Hospital Authority and being followed up in the medical endocrine clinic of the Pamela Youde Nethersole Eastern Hospital were identified in July 2011. This was performed using the Clinical Data Analysis and Reporting System of the Hospital Authority. Corresponding case notes and radiological imaging data were retrieved and reviewed. Patients with diagnostic X-ray or computed tomography findings of Paget's disease of bone were included in this series. The demographic data, clinical features, and investigation results of the cases were retrieved, recorded, and analysed.
RESULTS. Seven Chinese patients (5 men and 2 women; mean age, 66 years) diagnosed to have Paget's disease of bone from 2000 to 2010 were identified. All but one were asymptomatic and presented as an incidental finding (isolated raised serum alkaline phosphatase level or abnormal X-ray). The most commonly involved sites were the skull and pelvis. The majority (71%) of the patients had polyostotic disease. During follow-up, there were no diseaserelated complications, nor was malignant transformation identified. None reported positive family history.
CONCLUSION. In this series of seven Chinese patients with Paget's disease, most were asymptomatic and presented with an isolated raised serum alkaline phosphatase level during routine testing. The disease was predominantly found in males and the elderly, and commonly involved the skull and pelvis.
Key words: Alkaline phosphatase; Bone neoplasms; Osteitis deformans
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