eMedicine Specialties > Rheumatology > Metabolic and Bone Disease

Paget Disease: Follow-up

Author: Laura D Carbone, MD, MS, Professor of Medicine, Division of Connective Health Diseases, Director, Memphis Metabolic Bone Center, Department of Medicine, University of Tennessee Health Science Center College of Medicine
Coauthor(s): Karen Driver, MS, Medical Writer, Procter and Gamble Company; Kristine M Lohr, MD, MS, Program Director, Professor, Department of Internal Medicine, Division of Rheumatology and Women's Health, University of Kentucky School of Medicine; Marlon J Navarro, MD, Fellow, Department of Rheumatology, University of Tennessee at Memphis
Contributor Information and Disclosures

Updated: Oct 29, 2009

Follow-up

Further Inpatient Care

Inpatient care may be useful for surgical complications of Paget disease.

Further Outpatient Care

Response to therapy is indicated by reduction of symptoms and decreases in BSAP (bone formation marker) and deoxypyridinoline, C-telopeptide,1 or N -telopeptide (bone resorption markers) levels.

Deterrence/Prevention

No preventive measures for Paget disease are known.

Complications

Complications of Paget disease include deafness, spinal stenosis, stroke, vascular steal syndrome, congestive heart failure, fractures, osteoarthritis, sarcomas, nephrocalcinosis, and the development of bone tumors (principally sarcomas).

Prognosis

Many reports have described long-term remissions following successful treatment of Paget disease. However, if sarcomas arise in the setting of Paget disease, the prognosis is dismal and most patients die within 1-3 years of diagnosis.

Patient Education

Proper patient education on the nature of Paget disease is essential. The Paget Foundation for Paget's Disease of Bone and Related Disorders can provide useful information for patients. Call (800) 23-Paget (ie, [800] 237-2438).

Miscellaneous

Medicolegal Pitfalls

Careful follow-up of patients with Paget disease is indicated for life. Periodic monitoring of bone marker levels (every 3-6 mo in those without active disease) is recommended.

Special Concerns

Family members should be informed of the increased incidence of Paget disease in family members of the affected patient.

 


More on Paget Disease

Overview: Paget Disease
Differential Diagnoses & Workup: Paget Disease
Treatment & Medication: Paget Disease
Follow-up: Paget Disease
Multimedia: Paget Disease
References
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References

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Further Reading

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Keywords

Paget disease, Paget's disease, osteitis deformans, monostotic Paget disease, multifocal Paget disease, monostotic Paget’s disease, multifocal Paget’s disease, burned-out Paget disease, burned-out Paget’ disease, osteoporosis circumscripta, bone disorder, bone disease, woven bone, pagetic bone, bone inflammation, chronic bone inflammation, bone remodeling

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Contributor Information and Disclosures

Author

Laura D Carbone, MD, MS, Professor of Medicine, Division of Connective Health Diseases, Director, Memphis Metabolic Bone Center, Department of Medicine, University of Tennessee Health Science Center College of Medicine
Laura D Carbone, MD, MS is a member of the following medical societies: Alpha Omega Alpha, American College of Rheumatology, American Medical Women's Association, American Society for Bone and Mineral Research, and International Society for Clinical Densitometry
Disclosure: novartis Honoraria Consulting; P&G Honoraria Consulting; P&G Honoraria Speaking and teaching; novartis Honoraria Speaking and teaching

Coauthor(s)

Karen Driver, MS, Medical Writer, Procter and Gamble Company
Disclosure: The Procter & Gamble Company Salary Employment

Kristine M Lohr, MD, MS, Program Director, Professor, Department of Internal Medicine, Division of Rheumatology and Women's Health, University of Kentucky School of Medicine
Kristine M Lohr, MD, MS is a member of the following medical societies: American College of Physicians, American College of Rheumatology, and American Medical Women's Association
Disclosure: Nothing to disclose.

Marlon J Navarro, MD, Fellow, Department of Rheumatology, University of Tennessee at Memphis
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Elliot Goldberg, MD, Dean of the Western Pennsylvania Clinical Campus, Professor, Department of Medicine, Temple University School of Medicine
Elliot Goldberg, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and American College of Rheumatology
Disclosure: Nothing to disclose.

CME Editor

Alex J Mechaber, MD, FACP, Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine
Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Chief Editor

Herbert S Diamond, MD, Professor of Medicine, Temple University School of Medicine; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital
Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, and Phi Beta Kappa
Disclosure: medifocus Honoraria Review panel membership; health dialogs Honoraria Consulting; West Penn Allegheny Health System None Board membership

 
 
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