Osteoporosis regional migratoria: efecto de tratamiento con calcitonina: presentación de 2 casos / Regional migratory osteoporosis: effect of calcitonine treatment: report of 2 cases

ABSTRACT

We report two cases of regional migratory osteoporosis. One is a 41 years old male, with the classical form, presenting with succesive episodes of painful osteoporosis lasting for 5 months at the hip, knee and distal epiphysis of the right metatarsophalangeal joints. The second case is a 40 years old female presenting with an unusual disseminated form, lasting for 30 months, with succesive and simultaneous episodes of polyarticular and costal painful osteoporosis. An increased bone fraction of serum alkaline phosphatases and urine hydroxyproline/creatinine and calcium/creatinine ratios were detected. Imaging showed localized periarticular or costal oateoporosis. Bone biopsies disclosed a severe osteopenia with accelerated bone reabsorption. Bone scintigraphy precociously detected location, migration and evolution of lesions. Patients were treated with subcutaneous calcitonin, 100 U/day during 1 month and on alternative days posteriorly; this treatment alleviated pain but did not prevent the appearence of new crisis. Our observations suggest that regional migratory osteoporosis presentation may range from oligoarticular to disseminated forms and that calcitonin has a precocious and persistent analgesic effect