An Interesting Case of Peripheral Vascular Disease,Vascular Reperfusion,and Subsequent Development of Pain Due to Paget's Disease of Bone |
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| Affiliation: | 1. Division of Endocrinology, "V. Fazzi" Hospital, Lecce, Italy;2. Department of Pathology, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy;3. Department of Biomedical Sciences and Human Oncology, University of Turin, Turin, Italy;4. Endocrine Unit & Thyroid Diseases Center, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy;1. Servizio di Diabetologia, Policlinico Gemelli, Universita Cattolica, Rome, Italy;2. Global Research & Development, Novo Nordisk A/S, Søborg, Denmark;3. Practice for Internal Medicine and Diabetology, Frankfurt, Germany;4. Endocrinology, Diabetes, & Metabolism, Rambam Medical Centre and Faculty of Medicine, Technion, Haifa, Israel;5. University of Miami Miller School of Medicine, Miami, Florida;6. Department of Biostatistics & Epidemiology, Novo Nordisk A/S, Søborg, Denmark.;1. Department of Medicine;2. Division of Endocrinology and Metabolism, University of California, San Francisco, California;3. Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, New York;4. Division of Gastroenterology, University of California, San Francisco, California;1. Department of Internal Medicine, Eulji University College of Medicine, Republic of Korea;2. Department of Internal Medicine, Hanyang University College of Medicine, Republic of Korea;3. Department of Internal Medicine, Soonchunhyang University, Bucheon Hospital, Republic of Korea;4. Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Republic of Korea;5. Department of Internal Medicine, Konkuk University School of Medicine, Republic of Korea;6. Department of Internal Medicine, Yonsei University School of Medicine, Republic of Korea;7. Department of Internal Medicine, Kyung Hee University School of Medicine, Republic of Korea;8. Department of Internal Medicine, Kyungpook National University Hospital, Republic of Korea;9. Department of Internal Medicine, Korea University School of Medicine, Republic of Korea;10. Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea;11. Sahmyook Medical Center, Seoul, Republic of Korea |
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| Abstract: | ObjectiveTo present a case of Paget’s disease of bone that was unmasked after vascular reperfusion.MethodsIn this case study, we review the presentation, evaluation, diagnosis, and management of a patient with Paget’s disease and peripheral vascular disease.ResultsA 79-year-old-woman with a history of coronary artery heart disease and recent finding of a T5 compression fracture was hospitalized for evaluation of right lower extremity claudication. Angiography demonstrated a focal complete occlusion of the distal right femoral and popliteal arteries. A self-expanding stent was placed in the distal femoral and popliteal arteries. Approximately 48 hours after the procedure, the patient developed severe, right lower leg pain. On endocrine evaluation, the patient was found to have clinical signs suggesting Paget’s disease of bone, which was subsequently confirmed by imaging.ConclusionThis patient’s development of severe pain following reperfusion of distal femoral and popliteal arteries is in keeping with the known and aforementioned hypervascularity of pagetic bone. The finding of increased warmth over an area of skeletal deformation should always raise the possibility of Paget’s disease of bone.(Endocr Pract. 2013;19:e61-e63) |
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