[ON THE EFFICACY OF ACETYLSALICYLIC ACID IN THE TREATMENT OF PAGET'S OSTEITIS DEFORMANS].
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A rare association of prostatic adenocarcinoma with osteitis deformans (Paget's disease) is reported. The diagnosis suspected on the basis of simultaneous increased concentrations of acid and alkaline phosphatases was documented only through repeated biopsies of prostate.
Presented is a case of osteitis deformans (Paget's disease of bone) with a 38-year history after diagnosis. The patient had nearly the entire spectrum of symptoms that can result from widespread involvement of the skeletal system with this disease. Diffuse involvement of the maxilla and mandible resulted in postextraction complications which are common in Paget's disease of the bone.
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HLA genotyping was carried out on a two-generation family with familial osteitis deformans. No evidence of major histocompatibility linkage of the disease could be demonstrated.
The validity of individual radiological signs for the differentiation of osteoplastic bone metastases from osteitis deformans has been investigated quantitatively (103 skeletal metastases from carcinoma of the prostate, 45 cases of Paget's disease, two osteoplastic bone metastases from a carcinoma of rectum and bronchus). The similarities were demonstrated by three cases observed by us. Problems in the quantitative evaluation of the radiographs are discussed.
The prevalence of calcific aortic valve stenosis in Paget's disease (osteitis deformans) was investigated by reviewing autopsy data of severe cases (> or = 75% involvement of > or = 3 major bones, the femur, tibia, skull, and pelvis) and moderate cases (> or = 75% involvement of only 1 or 2 major bones) of Paget's disease. Comparisons were made with normal age-matched controls. Aortic stenosis (AS) was present in 24% of 27 autopsies of severe Paget's disease compared with 3.5% in 201 controls (p <0.01). Clinical signs of AS were present in 39% of 102 patients with severe Paget's disease compared with 4% in 417 controls (p <0.101). The prevalence of AS in 18 cases of moderate Paget's disease was similar to that of controls. Electrocardiograms were reviewed in 45 cases of Paget's disease and compared with 80 controls of similar age. Complete atrioventricular (AV) block, incomplete AV block, bundle branch block, and left ventricular hypertrophy were present in 11%, 11%, 20%, and 13% of the Paget's cases and in only 2.5%, 1.3%, 2.5%, and 3.8% in the control cases (p <0.05, <0.05, <0.01, and <0.05, respectively). It is concluded that in severe Paget's disease there is a high prevalence of AS, heart block, and bundle branch block, but these are not present in moderate degrees of bone involvement.
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