RESUMO
Osteopoikilosis (OPK) is a rare autosomal dominant bone disorder characterized by numerous hyperostotic areas that tend to localize in periarticular osseous regions. It is usually asymptomatic and is often diagnosed incidentally during X-rays. OPK may be an isolated finding or associated with other pathologies, e.g. skin manifestations, rheumatic and/or skeletal disorders. We report a literature review and, for the first time, the coexistence of OPK with seronegative spondyloarthritis and Raynaud's phenomenon in a 48-year old female. To the best of our knowledge, this is the first case of OPK studied by videocapillaroscopy, demonstrating the absence of specific microvascular abnormalities of nailfold capillaries.
Assuntos
Angioscopia Microscópica , Microscopia de Vídeo , Unhas/irrigação sanguínea , Osteopecilose/complicações , Doença de Raynaud/complicações , Espondilartrite/complicações , Artroplastia de Quadril , Sedimentação Sanguínea , Proteína C-Reativa/análise , Capilares/patologia , Feminino , Humanos , Angioscopia Microscópica/métodos , Pessoa de Meia-Idade , Osteoartrite do Quadril/complicações , Osteoartrite do Quadril/diagnóstico por imagem , Osteoartrite do Quadril/cirurgia , Osteopecilose/sangue , Osteopecilose/diagnóstico por imagem , Ossos Pélvicos/diagnóstico por imagem , Radiografia , Doença de Raynaud/patologia , Sacroileíte/complicações , Sacroileíte/diagnóstico por imagem , Espondilartrite/sangue , Espondilartrite/diagnóstico por imagemRESUMO
El término "distrofia ósea esclerosante mixta" describe la combinación de las características radiológicas correspondientes a melorreostosis, osteopoiquilosis y osteopatía estriada, como entidades individuales, que ocurren en un mismo paciente. El objetivo de esta comunicación es presentar el caso clínico de una paciente con diagnóstico de distrofia ósea esclerosante mixta y, a partir de este caso, realizar una revisión sobre el tema. (AU)
The term "mixed-sclerosing-bone-dystrophy" describes the combination of the radiological characteristics corresponding to melorheostosis, osteopoikilosis and osteopathia striata, as individual conditions, ocurring in the same patient. The aim of this communication is to present the clinical case of a patient diagnosed with mixed-sclerosing-bone-dystrophy and, based on this case, to undertake a review of this condition. (AU)
Assuntos
Humanos , Feminino , Adulto , Osteopecilose/diagnóstico , Doenças Ósseas Metabólicas/diagnóstico , Melorreostose/diagnóstico , Osteíte Deformante/diagnóstico , Osteíte Deformante/tratamento farmacológico , Osteíte Deformante/sangue , Osteopecilose/sangue , Radiologia , Tíbia/diagnóstico por imagem , Doenças Ósseas Metabólicas/sangue , Menopausa Precoce/metabolismo , Fêmur/diagnóstico por imagem , Pamidronato/administração & dosagem , Melorreostose/sangueRESUMO
BACKGROUND: Buschke-Ollendorff syndrome (BOS), an autosomal dominant disorder, features small, acquired, asymptomatic, symmetrical foci of osteosclerosis detected radiographically in epimetaphyseal bone (osteopoikilosis) (OPK) together with connective tissue nevi or juvenile elastomas. Heterozygous, loss-of-function, germline mutation in the LEMD3 gene (which encodes an inner nuclear membrane protein called LEMD3, or MAN1) has been repeatedly documented in patients with BOS or OPK. OBSERVATIONS: We describe a father and son with multiple yellowish papules and nodules coalescing into cobblestone nevoid plaques consistent with nevus elasticus. Radiographs of the father show multiple, small, bone islands within the hands, wrists, distal femurs, proximal tibias, and left distal fibula consistent with OPK. Although the clinical findings are diagnostic of Buschke-Ollendorf syndrome, analysis of the LEMD3 gene showed no exonic mutations. CONCLUSION: Absence of LEMD3 mutation in the exons and splice sites of a family with BOS suggests that there is genetic heterogeneity for this disorder.