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Enfermedad ósea de Paget
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Enfermedad ósea de Paget

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Enfermedad ósea de Paget

La enfermedad de Paget es un trastorno que involucra destrucción y regeneración anormal del hueso, lo cual causa deformidad.

Causas

No se conoce la causa de la enfermedad de Paget, aunque podría tener que ver con los genes o una infección viral temprana en la vida.

La enfermedad se presenta a nivel mundial, pero es más común en Europa, Australia y Nueva Zelanda.

En las personas que padecen esta enfermedad, hay una descomposición anormal del tejido óseo, seguida por una formación ósea anormal. El nuevo hueso es más grande, pero débil y lleno de vasos sanguíneos nuevos.

La enfermedad se puede localizar únicamente en una o en dos áreas del esqueleto o en todo el cuerpo. A menudo, compromete huesos de los brazos, la clavícula, la pierna, la pelvis, la columna y el cráneo.

Síntomas

La mayoría de los pacientes son asintomáticos. La enfermedad de Paget a menudo se diagnostica cuando se toma una radiografía por otra razón.

De presentarse, los síntomas pueden abarcar:

Dolor óseo, dolor o rigidez articular y dolor de cuello (puede ser intenso y presentarse la mayor parte del tiempo)

Arqueamiento de las piernas y otras deformidades visibles

Agrandamiento de la cabeza y deformidades del cráneo

Fractura

Dolor de cabeza

Hipoacusia

Rigidez o dolor articular

Disminución de estatura

Piel caliente sobre las áreas afectadas

Pruebas y exámenes

Los exámenes que pueden revelar enfermedad de Paget son:

Gammagrafía ósea

Radiografía ósea

Marcadores elevados de la descomposición del hueso (por ejemplo, N-telopéptido)

Aumento de la fosfatasa alcalina sérica

Esta enfermedad puede también afectar los resultados de los siguientes exámenes:

Isoenzima de la fosfatasa alcalina (ALP)

Calcio sérico

Tratamiento

Los pacientes que posiblemente no necesiten tratamiento comprende los que:

Tienen únicamente exámenes de sangre anormales.

No tienen ningún síntoma ni indicio de la enfermedad activa.

Los pacientes con enfermedad de Paget que son comúnmente tratadas abarcan personas que tienen:

Ciertos huesos, como los huesos que soportan peso, comprometidos o cambios óseos que están empeorando rápidamente (el tratamiento puede reducir el riesgo de fracturas).

Deformidades.

Dolor u otros síntomas.

Problemas con el cráneo para prevenir hipoacusia.

El tratamiento farmacológico ayuda a prevenir la descomposición mayor del hueso. Actualmente, hay varias clases de medicamentos empleados en el tratamiento de la enfermedad de Paget y abarcan:

Bifosfonatos: estos fármacos son el tratamiento de primera línea y ayudan a incrementar la densidad ósea. Se pueden tomar por vía oral o intravenosa (IV) con menos frecuencia.

Calcitonina: esta hormona está involucrada en el metabolismo de los huesos. Se puede administrar como aerosol nasal (Miacalcin) o como inyección subcutánea (Calcimar o Mithracin).

Igualmente, se puede administrar paracetamol (Tylenol) o antinflamatorios no esteroides (AINES) para el dolor. Se puede necesitar la cirugía ortopédica para corregir una deformidad en casos graves.

Grupos de apoyo

Para buscar ayuda y recursos adicionales, ver Paget Foundation.

Pronóstico

La actividad de la enfermedad y los síntomas generalmente se pueden controlar con medicamentos corrientes. Un pequeño porcentaje de pacientes puede desarrollar un cáncer de hueso llamado osteosarcoma. Algunos pacientes necesitarán una artroplastia.

Posibles complicaciones

Fracturas óseas

Sordera

Deformidades

Insuficiencia cardíaca

Paraplejia

Estenosis de la columna

Cuándo contactar a un profesional médico

Solicite una cita con el médico si presenta síntomas de la enfermedad de Paget.

Nombres alternativos

Osteítis deformante.  Medlineplus.

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