Presence of pyrophosphate in bone from an atypical femoral fracture site: A case report.
Presence of pyrophosphate in bone from an atypical femoral fracture site: A case report.
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DOI：
10.1016/j.bonr.2017.02.006
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发表时间：
2017-06
期刊：
影响因子：
2.5
通讯作者：
Diez-Perez A
中科院分区：
文献类型：
--
作者：
Shabestari M;Eriksen EF;Paschalis EP;Roschger P;Gamsjaeger S;Klaushofer K;Berzlanovich A;Nogues X;Puig L;Diez-Perez A
长期使用抗吸收剂与非典型股骨粗隆下和骨干骨折（AFF）有关，其发病机制尚不清楚。在本病例报告中，我们通过组织学、定量背散射电子成像和拉曼光谱分析分析了一位74岁女性患者的骨片，该患者曾接受阿仑膦酸盐、依班膦酸盐和地诺单抗治疗，并患有非典型股骨骨折。结果显示持续的破骨细胞吸收，但也有一些异常：1)骨细胞排列改变；2)矿化受损；3)焦磷酸盐的存在可能导致矿化受损，这在本案例中很明显。综上所述，这些变化可能导致该患者局部骨强度降低。
Long-term antiresorptives use has been linked to atypical subtrochanteric and diaphyseal femoral fractures (AFF), the pathogenesis of which is still unknown. In the present case report we present the results of analysis of bone chips from a 74-year old female patient that had been on alendronate, ibandronate and denosumab treatment, and who sustained an atypical femoral fracture, by histology, quantitative backscattered electron imaging, and Raman spectroscopic analysis. The results indicate ongoing osteoclastic resorption, but also several abnormalities: 1) an altered arrangement of osteons; 2) impaired mineralization; 3) the presence of pyrophosphate, which might contribute to the impaired mineralization evident in the present case. Taken together, these changes may contribute to the focally reduced bone strength of this patient.