Evidence for secular change in Paget's disease.
Death certification data has shown that death rates due to Paget's disease of bone and osteosarcoma in older people (assumed to be attributable to Paget's) declined in the latter part of the 19th and in the early 20th century, suggesting that there may be a secular trend toward less severe disease.
We have reviewed a 21 year experience in a clinic specializing in Paget's disease.
Data from all 1041 patients attending the clinic in this period were reviewed.
Despite an increase in the susceptible population and an increased rate of referral to the clinic over this time (p=0.012), there was a fall in the absolute numbers of patients referred with severe disease, as judged by the initial plasma alkaline phosphatase activity at presentation.
In the years 1973-1978 the initial plasma alkaline phosphatase was>500 U/L in an average of 22 new patients per year and>1000 U/L in 12 per year.
In the years 1988-1993, the figures were 12 and 3 per year, respectively.
During this period, there were no other facilities offering scintigraphy or intravenous treatment for Paget's disease in the Auckland region, making it unlikely that patients with severe disease were being seen and treated elsewhere.
The average age of newly referred patients rose steadily from a mean 62 years, in 1971-1973 to 71 years in 1991-1993 (p<0.001). 534 subjects had scintiscans (52%) from which the extent of skeletal involvement was calculated. (...)
Mots-clés Pascal : Os Paget maladie, Homme, Incidence, Epidémiologie, Forme clinique, Gravité, Nouvelle Zélande, Océanie, Système ostéoarticulaire pathologie, Ostéopathie
Mots-clés Pascal anglais : Paget disease of bone, Human, Incidence, Epidemiology, Clinical form, Gravity, New Zealand, Oceania, Diseases of the osteoarticular system, Bone disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0176377
Code Inist : 002B15A. Création : 21/05/1997.