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Paget's Disease - Causes, Symptoms and Treatment

 

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Paget's disease is a metabolic bone disease, occurring in the middle aged and elderly peoples. The other name of Paget's disease is osteitis deformans. It is a chronic condition in which both the breakdown and formation of bone tissue are increased, which result in deformity. It is most frequently occur in the pelvic and leg bones, skull, and lower spine. It may lead to bone pain, deformities, and fractures. Paget's disease may be caused by a "slow virus" infection, present for many years before symptoms appear. There is also a hereditary factor since the disease may appear in more than one family member. When an area of bone is destroyed in a person with Paget's disease, the bone that replaces it is soft and porous. Soft bone can be weak and easily bend, leading to shortening of the affected part of the body. The bone affected by Paget's disease also tends to have more blood vessels than normal. This causes an increase in the blood supply to the area, and as a result the area may feel warmer than usual.

Paget's disease can lead to other medical conditions including osteoarthritis, kidney stones and heart disease. The disease may affect only one or two areas of your body, or may be widespread. Paget's disease usually first affects the nipple, and then the surrounding tissue. Other skin conditions usually affect the areola first, and then spread into the nipple. The disease may localize to one or two areas within the skeleton, or become widespread. Frequently, bones of the pelvis, leg, spine, arm, or the collar bone are involved. The effect on the skull may enlarge head size and cause hearing loss, if the cranial nerves are damaged by the bone growth. Often, people with Paget's disease of bone have no symptoms at all and may not require treatment other than regular monitoring. But if signs or symptoms are troublesome, treatment for Paget's disease of bone is available in the form of medications or surgery.

Causes of Pagets disease

The cause of Paget's disease is not yet fully understood . Some scientists believe Paget's is related to a viral infection in your bone cells that may be present for many years before problems appear. Certain women seem to be at a higher risk of developing breast cancer. This includes women who have never had children, or had them late in life, women who started their periods at a young age or who had a late menopause, and women who have a strong family history of breast cancer. Hereditary factors seem to influence whether you're susceptible to the disease.

Common causes and risk factors of Pagets disease:

  • Viral infection.
  • Heredity problem.
  • A 'slow virus' infection of bone cells.

Signs and Symptoms of Pagets disease

Paget's disease of bone affects each person differently. Most people with Paget's disease have no symptoms. Sometimes, symptoms may be confused with those of arthritis or other disorders. In other cases, the diagnosis is made only after complications have developed. The first symptom is usually an eczema-like rash, as described earlier. Some women have an itching or burning sensation. There may or may not be a lump in the breast. When a blood test turns up an elevated level of alkaline phosphatase, a bone scan is ordered to help rule out other possibilities such as metastatic cancer that has spread to the bone.

Sign and symptoms may include the following :

  • Headaches.
  • An eczema like rash.
  • Joint pain or joint stiffness.
  • Bone pain.
  • Pressure on nerves.
  • Reduced height.
  • Hearing loss.

Treatment for Pagets disease

Drug therapy is aimed at suppressing bone breakdown. A group of prescription drugs known as bisphosphonates have been shown to be helpful in rebuilding bone, and so are used to treat Paget's disease and other bone diseases. If you have severe pain and bone loss your doctor may prescribe a medication called calcitonin, which is given by injection. Calcitonin is a hormone that occurs naturally within the body.  It helps increase bone density by affecting the levels of calcium in the blood. Localized Paget's disease requires no treatment, if there are no symptoms and no evidence of active disease. Orthopedic surgery may be required to correct a specific deformity in severe cases.

Treatment may include:

  • Analgesics can also be used for the fast recovery from paget's disease.
  • Fractures are most common in the femur and tibia, and are usually treated with an intramedullary rod, a rod that is inserted within the marrow cavity in the center of the bone.
  • The nonsteroidal anti-inflammatory drugs like aspirin and ibuprofen are usually effective for getting relief from pain.
  • Sometimes surgery is needed if there is a significant bone deformity or if there is a break in the bone.