Open Access

Paget's disease of bone and megaloblastic anemia in a 72‑year‑old patient: A case report and systematic literature review

  • Authors:
    • Violeta Diana Oprea
    • Violeta Claudia Bojincă
    • Andra-Rodica Bălănescu
    • Alin Laurențiu Tatu
    • Mihai Bojincă
    • Aurelia Romila
  • View Affiliations

  • Published online on: February 8, 2022     https://doi.org/10.3892/etm.2022.11195
  • Article Number: 269
  • Copyright: © Oprea et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Paget's disease of bone (PDB) is characterized by abnormal osteoclastic bone resorption with disorganized bone neo‑formation, primarily affecting elderly (>55 years) patients. Although the majority of patients are asymptomatic, some patients may experience bone pain due to local periosteal involvement or osteoarthritic lesions in the spine; in addition, limb deformities may lead to secondary gait problems or degenerative joint changes. Anemia has an overall prevalence of 12‑17% in elderly adults (>65 years old), with macrocytic anemia being the less common type. Megaloblastic anemia is a macrocytic anemia characterized by the presence of large, immature, nucleated cells (megaloblasts) in the blood, with the most common cause being a deficiency of folate and/or vitamin B12. We herein report the rare case of a 72‑year‑old male patient exhibiting both these conditions, with the aim of discussing the possible association between the two and, most importantly, the clinical management of the patient in a real‑life setting over a period of 10 years. The patient was diagnosed based on clinical symptoms (bone pain), radiological imaging and specific laboratory tests, and received discontinuous courses of bisphosphonates and cyanocobalamin supplementation therapy, based mainly on aggravated symptomatology. A systematic literature review was also performed and revealed not only the scarcity of reports on similar cases, but also the mechanisms that may underlie the possible association of PDB with macrocytic anemia due to vitamin B12 deficiency in elderly patients.
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April-2022
Volume 23 Issue 4

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Oprea VD, Bojincă VC, Bălănescu A, Tatu AL, Bojincă M and Romila A: Paget's disease of bone and megaloblastic anemia in a 72‑year‑old patient: A case report and systematic literature review. Exp Ther Med 23: 269, 2022
APA
Oprea, V.D., Bojincă, V.C., Bălănescu, A., Tatu, A.L., Bojincă, M., & Romila, A. (2022). Paget's disease of bone and megaloblastic anemia in a 72‑year‑old patient: A case report and systematic literature review. Experimental and Therapeutic Medicine, 23, 269. https://doi.org/10.3892/etm.2022.11195
MLA
Oprea, V. D., Bojincă, V. C., Bălănescu, A., Tatu, A. L., Bojincă, M., Romila, A."Paget's disease of bone and megaloblastic anemia in a 72‑year‑old patient: A case report and systematic literature review". Experimental and Therapeutic Medicine 23.4 (2022): 269.
Chicago
Oprea, V. D., Bojincă, V. C., Bălănescu, A., Tatu, A. L., Bojincă, M., Romila, A."Paget's disease of bone and megaloblastic anemia in a 72‑year‑old patient: A case report and systematic literature review". Experimental and Therapeutic Medicine 23, no. 4 (2022): 269. https://doi.org/10.3892/etm.2022.11195