Hypertryptasemia and mast cell-related disorders in severe osteoporotic patients: Mediators of Inflammation

G. Carosi, G. Guabello, M. Longhi, F. Grifoni, E. Passeri, S. Corbetta

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose. Systemic mastocytosis (SM) is characterized by a clonal proliferation of neoplastic mast cells (MCs) in one or more extracutaneous organs including the bone marrow (BM). SM is often associated with osteoporosis (OP) and fractures. Hypertryptasemia usually occurs in SM. We investigated the prevalence of hypertryptasemia in a series of severe osteoporotic patients, the performance of the tryptase test in diagnosing SM in these patients, and their bone features. Methods. The medical records of 232 patients (168 females and 64 males) with a diagnosis of OP (50.4% with fractures) and a serum tryptase assessment were reviewed. BM assessment was performed in a subset of hypertryptasemic patients; clinical, biochemical, and radiographic data were collected. Results. Hypertryptasemia was detected in 33 patients. BM assessment (n = 16) was normal in 8 hypertryptasemic patients, while BM criteria for the diagnosis of SM were met in 3 patients, MC alterations were detected in 4 patients, and one patient presented a polycythemia vera. Serum tryptase levels were higher than 11.4 ng/ml in all patients with BM alterations. The best cut-off of tryptase level related to BM alterations was 17.9 ng/ml, with a sensibility and sensitivity of 75% (AUC = 0:797 and P = 0:015 by ROC analysis). All osteoporotic patients with hypertryptasemia experienced at least one vertebral fracture associated with a severe reduction of the lumbar bone mineral density. Conclusions. The prevalence of MC-related disorders in severe OP was 3.0%, accounting for the 7.4% of the secondary causes of OP. MC-related disorders may be involved in bone fragility and assessment of serum tryptase is useful to detect MC-related disorders.

Original languageEnglish
Article number5785378
Pages (from-to)5785378
JournalMediators Inflamm.
Volume2020
DOIs
Publication statusPublished - 2020

Keywords

  • 25 hydroxyvitamin D
  • alendronic acid
  • alkaline phosphatase
  • calcium
  • CD2 antigen
  • denosumab
  • interleukin 2 receptor alpha
  • parathyroid hormone
  • parathyroid hormone[1-34]
  • phosphate
  • risedronic acid
  • tryptase
  • abnormally high substrate concentration in blood
  • adult
  • aged
  • alkaline phosphatase blood level
  • Article
  • biochemical analysis
  • bone density
  • bone fragility
  • bone metabolism
  • calcium blood level
  • calcium metabolism
  • clinical outcome
  • disease association
  • disease severity
  • dual energy X ray absorptiometry
  • female
  • fragility fracture
  • genotype
  • human
  • hypertryptasemia
  • immunohistochemistry
  • major clinical study
  • male
  • middle aged
  • oncogene c kit
  • osteoporosis
  • parathyroid hormone blood level
  • phosphate blood level
  • polycythemia vera
  • predictive value
  • prevalence
  • protein blood level
  • restriction fragment length polymorphism
  • reverse transcription polymerase chain reaction
  • Sanger sequencing
  • sensitivity and sensibility
  • spine fracture
  • systemic mastocytosis
  • vitamin blood level

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