Erdheim-Chester disease : a case report

We report the case of a 47-year-old woman with unexplained inflammatory syndrome and asthenia. Imaging findings show bilateral abnormalities of femurs and tibias, suggesting an Erdheim-Chester disease, which is confirmed by a bone marrow biopsy of the left femur. The BRAF V600E mutation is detected, allowing the administration of targeted therapies such as BRAF and MEK inhibitors that lead to the improvement of symptoms

One Year's Treatment of Paget's Disease of Bone by Synthetic Salmon Calcitonin as a Nasal Spray

The effectiveness of synthetic salmon calcitonin (SCT) administered as a nasal spray was assessed via clinical, biological, and radiological variables in 17 previously untreated Pagetic patients over a 1-year course of therapy. The results showed a highly significant decrease of serum alkaline phosphatase (S-ALP) (p less than 0.05 after 1 month of treatment) and of the urinary hydroxyproline/creatinine ratio (OH/Cr) (p less than 0.01 after 1 month of treatment). For the whole group, the mean decrease in S-ALP was 37 +/- 4% (SEM) after 6 months (p less than 0.01) and 31 +/- 5% after 1 year (p less than 0.01). The mean fall in OH/Cr was 35 +/- 6% (SEM) (p less than 0.01) and 37 +/- 7% (p less than 0.01) after 6 and 12 months, respectively. None of the usual side-effects of SCT were reported and local tolerance was excellent throughout the study

The Effect of Nasal hCT on Bone Turnover in Paget's Disease of Bone--Implications for the Treatment of Other Metabolic Bone Diseases

Thirty pagetic patients were treated for 6 months with a daily nasal application of 2 mg of synthetic human calcitonin (hCT). Serum alkaline phosphatases (SAP) and urinary hydroxyproline/creatinine ratio (OH/Cr), reflecting bone turnover, were significantly reduced from the first month of treatment (mean +/- SEM: SAP, -13.9 +/- 2.2%; OH/Cr, -22.2 +/- 5.8%; both P less than 0.01) and until the end of the 6-month course (mean +/- SEM: SAP, -29.7 +/- 4.6%; OH/Cr, -22.5 +/- 5.9%; both P less than 0.01). Nasal hCT was perfectly tolerated both locally and systemically. These results allow us to consider nasal hCT for long-term trials in metabolic bone diseases characterized by a relative increase of bone resorption

Un an de traitement de la maladie osseuse de Paget par spray nasal de calcitonine de saumon

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Biological and Clinical Assessment of a New Bisphosphonate, (Chloro-4 Phenyl) Thiomethylene Bisphosphonate, in the Treatment of Paget's Disease of Bone

Several Biophosphonates have been used as therapeutic agents for Paget's bone disease. (Chloro-4 phenyl)thiomethylene-bisphosphonate (CIPsMBP) has recently been shown to have significant antiosteoclastic activity while an affect of CIPsMBP on mineralization was only observed at high doses. We tested this drug for 6 months in 23 pagetic patients distributed in three groups. Gr 1 (n = 5) receiving 200 mg/day showed a decrease of serum alkaline phosphatase (SAP) to 42 +/- 4% (p less than 0.01) of initial value (100%) while hydroxyprolinuria/creatinuria ratio (OH/Cr) dropped to 69 +/- 8% of baseline. In 4 patients receiving 400 mg/day, SAP improved to 48 +/- 9% of initial value (p less than 0.01) and OH/Cr to 40 +/- 3% (p less than 0.01). In the last group (n = 14) receiving 200 mg/day for 3 months, and 400 mg/day thereafter up to the 6th month SAP decreased to 53 +/- 4% and OH/Cr to 62 +/- 6% of initial value (p less than 0.01). Clinical improvement was significant from the first month of treatment. No resistance (mean decrease of SAP lower than 30%) was recorded and no radiological or clinical evidence of mineralization defect appeared. The clinical and biological tolerance was excellent throughout the study

Effets biologiques et cliniques d'un nouveau bisphosphonate (chloro-4-phényl) thiométhylène bisphosphonate dans la maladie osseuse de Paget

peer reviewe