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Hepatitis C-associated Osteosclerosis (HCAO): Long-Term Follow-Up of a New Case Recovered After Antiviral Treatment

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Abstract

Hepatitis C-associated osteosclerosis (HCAO) is a very rare condition that can be observed in a small number of patients with Hepatitis C Virus (HCV) infection. HCAO is usually characterized by widespread bone sclerosis, associated with severe bone pain, and increased levels of bone turnover markers, especially alkaline phosphatase (ALP). In this report, we present the case of a 55-year-old woman who was affected by HCV and came to our attention for severe and diffuse bone pain. Radiological studies showed bone sclerosis, and bone mineral density (BMD) was markedly increased, as well as serum ALP levels. The patient was initially treated with intravenous pamidronate, which provided only a transient benefit on clinical symptoms. Then antiviral therapy for HCV (interferon-alfa and ribavirin) was started and it was effective in making the viral load undetectable. After a long follow-up period, we observed a persistent remission of bone pain, a reduction in BMD together with a progressive trend toward the normalization of bone turnover markers. In conclusion, HCAO, although rare, should be considered among the potential causes of increased bone mass in patients with HCV infection, and treatment for the underlying infection may be effective in controlling the manifestations of this disease.

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Acknowledgements

The authors would like to thank the patient for participation in this work.

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No funding was received to assist with the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Medicine, Clinica Medica 1, University of Padua, Via Giustiniani 2, 35128, Padua, Italy

    Gaetano Paride Arcidiacono, Carlo Poci, Stefania Sella, Marco Onofrio Torres, Francesca Zanchetta, Alberta Cecchinato, Martin Diogo, Mor Peleg Falb & Sandro Giannini

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  1. Gaetano Paride Arcidiacono
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  2. Carlo Poci
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Contributions

GPA: Conceptualization, Formal analysis, Investigation, Supervision, Writing—original draft, Writing—review & editing. CP: Conceptualization, Formal analysis, Investigation, Writing—review & editing. SS: Formal analysis, Supervision, Writing—review & editing. MOT: Formal analysis, Writing—review & editing. FZ: Formal analysis, Writing—review & editing. AC: Formal analysis, Writing—review & editing. MD: Formal analysis, Writing—review & editing. MPF: Formal analysis, Writing—review & editing. SG: Formal analysis, Supervision, Writing—review & editing.

Corresponding author

Correspondence to Gaetano Paride Arcidiacono.

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Competing Interests

Gaetano Paride Arcidiacono, Carlo Poci, Stefania Sella, Marco Onofrio Torres, Francesca Zanchetta, Alberta Cecchinato, Martin Diogo, Mor Peleg Falb, Sandro Giannini these authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. The patient has provided informed consent for the submission of the case report to the journal.

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Arcidiacono, G.P., Poci, C., Sella, S. et al. Hepatitis C-associated Osteosclerosis (HCAO): Long-Term Follow-Up of a New Case Recovered After Antiviral Treatment. Calcif Tissue Int 113, 571–577 (2023). https://doi.org/10.1007/s00223-023-01135-7

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