paget's disease...??? is going on

[aashkab]

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Questions about paget's disease as seen in FA with some extra WORLD knowledge.

Is it a disease of osteoblasts and osteoclasts evenly? or is it predominantly a disease of osteoblasts? or is it predominantly a disease of osteoclasts?

I would think its a predominantly a disease of osteoblasts because of increased hat size, auditory foramen narrowing, and increased ALP (ALP is an osteoblast activity marker where TRAP, urinary hydroxyproline/deoxypridinoline are osteoclast (got this from WORLD)).

But, the DIT guy said its predominantly a disease of osteoclasts and thats why you give bisphosphonates to treat it.

It is also relatively asymptomatic in most people, so in these lucky individuals, is it a disease of equal activity? and am i on the right track in assuming that the see saw between osteoclasts/osteoblast can tip any which way?

thanks SDN! and no thanks to you paget for being so complicated!

 

[kryptik]

http://emedicine.medscape.com/article/334607-overview

 

[Ableton]

Initial osteoclastic phase with bone resorption, late osteoblastic phase with bone formation (which I believe is where it becomes symptomatic).

 

[PokerDoc]

osteoclasts INITIATE the disease and then osteoblasts reform bone in a disorganized pattern..

so if the question asks what the first actor is , its osteoclasts, not blasts