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Written by Amanda Wattson, MD
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Saturday, 07 November 2009 |
Paget disease is a condition that causes alternating cycles of bone destruction and bone reconstruction. This disease tends to slowly get worse over time.
What is going on in the body?
Paget disease alternately destroys and then reconstructs bone. Normal bone is replaced with excessive amounts of abnormal bone. The abnormal bone has less calcium and is weaker.
What are the causes and risks of the disease?
The cause of Paget disease remains unclear. Some theories about the cause of Paget disease include:
- an autoimmune disorder, in which a person's immune system attacks his or her own body
- a genetic disorder, since the condition often occurs in more than one family member
- a hormone disorder, in which the body produces abnormal amounts of hormones that regulate bone maintenance
- an inflammatory condition or an immune response to injury
- a metabolic disorder, or abnormalities in physical and chemical processes within the body
- a slow viral infection
Paget disease is thought to affect about 3% of the population older than 40. The disease is twice as common in males. Paget disease is also more common in the United Kingdom, Australia, and New Zealand. It is less common in Asia, Africa, and Scandinavia. In the U.S., it is more common in the northern states and less common in the southern states.
What are the treatments for the disease?
Often, a person with no symptoms is not treated. A person who does have symptoms is usually treated with medicines. Examples are nonsteroidal anti-inflammatory medicines such as ibuprofen. Medicines may be used to inhibit bone destruction and reduce pain in people with more severe disease. These include calcitonin and biphosphonates. Biphosphonates include risedronate, alendronate, and pamidronate.
Other treatments that are used for Paget disease include:
- eating a diet rich in calcium and vitamin D
- following an exercise program prescribed by the healthcare provider
- taking calcium, magnesium, and boron supplements to support bone growth
- taking glucosamine, a supplement that is also used for arthritis
Long-term treatment may be needed if the disease is severe, especially if the person has nervous system problems. Adaptive equipment, such as canes and crutches, may be needed. Physical therapy may be ordered to maintain mobility and function. Surgery may be required for severely affected bones.
What are the side effects of the treatments?
All medicines can have side effects, including allergic reactions. For example, calcitonin may cause nausea and skin flushing. Herbal remedies may interfere with prescription medicines and cause bleeding problems. Surgery can cause bleeding, infection, and allergic reactions to anesthesia.
What happens after treatment for the disease?
Paget disease often requires lifelong treatment. If the symptoms go away, treatment may be stopped for a while.
How is the disease monitored?
A person with Paget disease will have regular visits with the healthcare provider. Blood and urine tests may also be performed. Any new or worsening symptoms should be reported to the provider.
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