Osteoporose bei Mastozytose

Eine Zusammenstellung universitätsmedizinischer Daten

osteoporosis in mastocyrosis

a collection of university medical data

by Sebastian Reid
Doctoral thesis
Date of Examination:2017-08-02
Date of issue:2017-08-02
Advisor:Prof. Dr. Heide Siggelkow
Referee:PD Dr. Timo Buhl
Referee:Prof. Dr. Margarete Schön
Persistent Address: http://dx.doi.org/10.53846/goediss-6387

 

 

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Abstract

English

Mastocytosis as a cause of secondary osteoporosis is frequently underestimated. Osteoporosis is associated with an increased risk for fractures, which increases morbidity and mortality. It is a retrospective study consisting of data from the Department of Dermatology of UMG and the Endokrinologikum Goettingen. Altogether 71 patients with mastocytosis and 22 patients with a clinical suspected mastocytosis belonged to our collective. Of the 71 patients with the diagnosis mastocytosis, 26 patients had indolent systemic and 41 had a cutaneous form. 30 (77%) of the patients with bone mineral density (BMD) measurements had osteopenia or osteoporosis. These patients had a mean age of 49 years (SD ±15,1). We found a significant negative correlation between serum tryptase and t-score of lumbar spine (p<0,05). However, there was a significant negative correlation between age and BMD (p<0.05). Both patients with cutaneous and with indolent systemic mastocytosis had decreased BMD- especially at lumbar spine (trabecular bone). It was shown for our collective that a decreased BMD is especially- but not solely- an important complication in mastocytosis for male patients. A decreased BMD seems to play an important role in cutaneous mastocytosis, too. Particularly trabecular bone seems to be affected. In our collective the correlation of serum tryptase was independent to age and body mass index. Serum tryptase can be useful as an indicator for bone complications in mastocytosis. There are indices that an elevated serum tryptase can be an indicator for fracture risk. The question remains, weather bone resorption markers such as bone-specific alkaline phosphatase could be complementary to BMD to assess the risk of osteoporosis for patients with mastocytosis. The role of Sclerostin, RANK and RANKL in mastocytosis-related osteoporosis should be further investigated in future studies.
Keywords: mastocytosis; osteoporosis; serum tryptase; bone mineral density
 
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