EN PL
CASE REPORT
Zoledronic acid in the treatment of secondary osteoporosis due to homocystinuria
 
More details
Hide details
 
Online publication date: 2010-05-14
 
 
Reumatologia 2010;48(2):133-138
 
KEYWORDS
ABSTRACT
We present a case of a 22-year-old woman admitted to our hospital because of low back pain. The patient, with a history of homocystinuria, inherited autosomal recessive amino acid metabolism disorder characterized by abnormalities of the eye, central nervous system, cardiovascular system, skeleton, and connective tissue.
The vertebral fracture assessment (VFA) by dual X-ray absorptiometry (DXA) detected multilevel (T4-L4) thoracic and lumbar spinal fractures. Both lumbar spine (L1-L4) and total body bone densitometry revealed significantly lower bone mineral density than expected for sex and age. The patient received treatment with zoledronic acid (Aclasta), a bisphosphonate applied in a once-yearly intravenous infusion. We did not observe any adverse effects and the patient still remains in follow-up study.
Osteoporosis associated with homocystinuria is one of the clinical manifestations of the disease. Bone tissue metabolism, bone mineral density and spinal cord structural changes monitoring, using VFA by DXA, during therapy with bisphosphonates may play an important role in evaluation of effects of administered treatment.
 
REFERENCES (13)
1.
Levaseur R. Bone tissue and hyperhomocysteinemia. J Bone Spine 2009; 76: 234-240. .
 
2.
Parrot F, Redonnet-Vernhet I, Lacombe D, Gin H. Osteoporosis in late-diagnosed adult homocystinuric patients. J Inherit Metab Dis 2000; 23: 338-340. .
 
3.
Grados F, Fechtenbaum J, Flipon E, et al. Radiographic methods for evaluating osteoporotic vertebral fractures. J Bone Spine 2009; 76: 241-247. .
 
4.
Lubec B, Fang-Kircher S, Lubec T, et al. Evidence for McKusick’s hypothesis of deficient collagen cross-linking in patients with homocystinuria. Biochim Biophys Acta 1996; 1315: 159-162. .
 
5.
Zhu K, Beilby J, Dick I M, et al. The effects of homocysteine and MTHFR genotype on hip bone loss and fracture risk in elderly women. Osteoporos Int 2009; 20: 1183-1191. .
 
6.
Herrmann M, Widmann T, Colaianni G, et al. Increased osteo­clast activity in the presence of increased homocysteine concentrations. Clin Chem 2005; 51: 2348-2353. .
 
7.
Gerdhem P, Ivaska KK, Isaksson A, et al. Associations between homocysteine, bone turnover, BMD, mortality, and fracture risk in elderly women. J Bone Miner Res 2007; 22: 127-134. .
 
8.
van Meurs JB, Dhonukshe-Rutten RA, Pluijm SM, et al. Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med 2004; 350: 2033-2041. .
 
9.
Cagnacci A, Baldassari F, Rivolta G, et al. Relation of homocysteine, folate, and vitamin B12 to bone mineral density of postmenopausal women. Bone 2003; 33: 956-959 .
 
10.
McLean RR, Jacques PJ, Selhub J, et al. Homocysteine as a predictive factor for hip fracture in older persons. N Eng J Med 2004; 350: 2042-2049. .
 
11.
Ezra A, Golomb G. Administration routes and delivery systems of bisphosphonates for the treatment of bone resorption. Adv Drug Deliv Rev 2000; 42: 175-195. .
 
12.
Recker R, Delmas P, Halse J, et al. Effects of intravenous zoledronic acid once yearly on bone remodeling and bone structure. J Bone Miner Res 2008; 23: 6-16. .
 
13.
Roux C. Potential effects of bisphosphonates on bone ultrastructure. Osteoporos Int 2009; 20: 1093-1095.
 
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
eISSN:2084-9834
ISSN:0034-6233
Journals System - logo
Scroll to top