Clin Osteol 2020; 25(2): 85-91

Osteoporosis on systemic mastocytosis: case reportCase reports

Vaňuga Peter1, Ságová Ivana1, Kulich Michal1, Vaňuga Anton1,2
1 Endokrinologické oddelenie, Národný endokrinologický a diabetologický ústav n. o. (NEDÚ), Ľubochňa
2 Alpha medical, s. r. o., Martin

Mastocytóza je raritné ochorenie, ktoré je charakterizované abnormálnou proliferáciou mastocytov, so širokým spektrom klinických prejavov v dôsledku postihnutia rôznych tkanív a orgánov. Častou manifestáciou systémovej mastocytózy, najmä v dospelosti, je osteoporóza. Najčastejším miestom postihnutia je lumbálna chrbtica, v dôsledku väčšej straty trabekulárnej kosti v porovnaní s kortikálnou kosťou. Patomechanizmus vzniku osteoporózy pri mastocytóze je multifaktoriálny. K osteoporóze dochádza jednak v dôsledku neoplastickej infiltrácie kostnej drene mastocytmi, najmä však vplyvom uvoľnených mediátorov z mastocytu ako napr. histamínu, heparínu, prosta­glandínov, cytokínov, ktoré zvyšujú aktivitu osteoklastov, a tým aj kostnú resorpciu. V liečbe osteoporózy pri mastocytóze sú indikované najmä bisfosfonáty, ďalšou alternatívou je denosumab. V našej kazuistike popisujeme prípad 33-ročnej pacientky s anamnézou urticaria pigmentosa, s ťažkou manifestnou osteoporózou s kompresívnymi fraktúrami torakálnej a lumbálnej chrbtice na podklade agresívnej formy systémovej mastocytózy.

Keywords: osteoporosis; bisphosphonates; Bone resorption; denosumab; systemic mastocytosis

Published: December 11, 2020  Show citation

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Vaňuga P, Ságová I, Kulich M, Vaňuga A. Osteoporosis on systemic mastocytosis: case report. Clinical Osteology. 2020;25(2):85-91.
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