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Longitudinal Evaluation of Bone Mineral Density and Bone Metabolism Markers in Patients with Indolent Systemic Mastocytosis Without Osteoporosis

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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.

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Authors and Affiliations

  1. Hematology Section, Department of Medicine, University of Verona, Verona, Italy

    A. Artuso, M. Bonifacio & R. Zanotti

  2. Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy

    C. Caimmi, G. Tripi, O. Viapiana, L. Idolazzi, I. Gavioli, D. Gatti & M. Rossini

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  1. A. Artuso
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  2. C. Caimmi
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  3. G. Tripi
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  4. O. Viapiana
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  5. M. Bonifacio
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  6. L. Idolazzi
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  7. I. Gavioli
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  8. D. Gatti
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  9. R. Zanotti
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  10. M. Rossini
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Correspondence to C. Caimmi.

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Conflict of interest

A. Artuso, C. Caimmi, G. Tripi, O. Viapiana, M. Bonifacio, L. Idolazzi, I. Gavioli, D. Gatti, R. Zanotti and M. Rossini have no conflicts of interests to disclose.

Human and Animal Rights and Informed Consent

The study was conducted in accordance with the ethics principles of the Declaration of Helsinki and was approved by the local ethics committees. All patients gave their informed consent prior to their inclusion in the study.

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Artuso, A., Caimmi, C., Tripi, G. et al. Longitudinal Evaluation of Bone Mineral Density and Bone Metabolism Markers in Patients with Indolent Systemic Mastocytosis Without Osteoporosis. Calcif Tissue Int 100, 40–46 (2017). https://doi.org/10.1007/s00223-016-0198-3

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  • DOI: https://doi.org/10.1007/s00223-016-0198-3

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