High prevalence of fractures and osteoporosis in patients with indolent systemic mastocytosis

• Published in: Allergy (Copenhagen) 2012-03, Vol.67 (3), p.431-438
• Main Authors: van der Veer, E., van der Goot, W., de Monchy, J. G. R., Kluin-Nelemans, H. C., van Doormaal, J. J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Bone Density; Dermatology; Diseases of the osteoarticular system; Female; Femur Neck - diagnostic imaging; Fractures; Fractures, Bone - diagnostic imaging; Fractures, Bone - epidemiology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Histamine - metabolism; Humans; Immune system; Lumbar Vertebrae - diagnostic imaging; Male; mastocytosis; Mastocytosis, Systemic - diagnostic imaging; Mastocytosis, Systemic - epidemiology; Mastocytosis, Systemic - physiopathology; Medical disorders; Medical sciences; methylhistamine; Middle Aged; Osteoporosis; Osteoporosis - diagnostic imaging; Osteoporosis - epidemiology; Osteoporosis. Osteomalacia. Paget disease; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - epidemiology; Prevalence; Radiography; Risk factors; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Spine; tryptase; Tryptases - blood
• ISSN: 0105-4538; 1398-9995
• DOI: 10.1111/j.1398-9995.2011.02780.x

Background:  Indolent systemic mastocytosis (ISM) is a rare disease characterized by accumulation of abnormal mast cells in various tissues, including bone marrow. Symptoms are usually related to release of mast cell mediators. The aims are to establish the prevalence of osteoporotic fractures in ISM and to investigate the association with serum tryptase and the urinary histamine metabolites, methylhistamine (MH), and methylimidazole acetic acid. Methods:  The fracture prevalence in 157 patients (65 men; 92 women), mean age 54 ± 12 years, was assessed by vertebral morphometry and data from patient records, supplemented by a questionnaire. Bone mineral density (BMD) of lumbar spine and femoral neck was measured, and tryptase and histamine metabolites were analysed. Results:  We registered 235 lifetime fractures in 154 patients, including 140 osteoporotic (low‐energy trauma) fractures, of which 62% were vertebral, 1% hip and 36% other nonvertebral fractures. Osteoporotic fractures and osteoporosis were found in 37% and 28% of the patients, respectively. In men, the prevalence of these osteoporotic manifestations (46%