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Evidence of Reduced Bone Turnover and Disturbed Mineralization Process in a Boy with Stickler Syndrome

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Abstract

We describe a tall-statured 14-year-old boy who illustrated the full phenotypic and radiographic features of Stickler syndrome type I. A bone biopsy showed evidence of reduced bone mass and bone turnover, such as reduced BV/TV (–43%), TbTh (–29%), and OS/BS (–48%), Ob.S/BS (–27%), and Oc/BS (–47%) compared to “age-matched” controls. Moreover, there was evidence that the mineralization process was severely disturbed. Quantitative backscattered electron imaging revealed that the bone mineralization density distribution (BMDD) of cancellous (Cn) as well as cortical (Ct) bone was shifted toward lower mineralization compared to a young control reference cohort. BMDD parameters of mean degree of mineralization, Cn Ca (–9.8%) and Ct Ca (–18.0%), were dramatically decreased. To the best of our knowledge this is the first clinical report describing bone biopsy findings in a boy with Stickler syndrome. Such a severe undermineralization of bone matrix might essentially contribute to the compromised mechanical competence of the skeleton found in this patient.

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Acknowledgments

The authors would like to thank Gerda Dinst, Daniela Gabriel, and Phaedra Messmer for careful sample preparation and qBEI measurements. This study was supported by the AUVA (Austrian Social Insurance for Occupational Risk) and the WGKK (Social Health Insurance Vienna).

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Authors and Affiliations

  1. Ludwig-Boltzmann Institute of Osteology, Hanusch Hospital of WGKK, and AUVA Trauma Centre Meidling, 4th Medical Department, Heinrich Collin-Strasse 30, 1140, Vienna, Austria

    A. Al Kaissi, P. Roschger, K. Nawrot-Wawrzyniak & K. Klaushofer

  2. Paediatric Department, Orthopaedic Hospital of Speising, Vienna, Austria

    A. Al Kaissi, A. Krebs & F. Grill

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  1. A. Al Kaissi
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  2. P. Roschger
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  3. K. Nawrot-Wawrzyniak
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  4. A. Krebs
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  5. F. Grill
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  6. K. Klaushofer
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Correspondence to A. Al Kaissi.

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Al Kaissi, A., Roschger, P., Nawrot-Wawrzyniak, K. et al. Evidence of Reduced Bone Turnover and Disturbed Mineralization Process in a Boy with Stickler Syndrome. Calcif Tissue Int 86, 126–131 (2010). https://doi.org/10.1007/s00223-009-9324-9

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  • DOI: https://doi.org/10.1007/s00223-009-9324-9

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