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Maria Stella Graziani

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Martina Zaninotto

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Ferruccio Ceriotti
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Giuseppe Agosta

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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da M.A. Crivellaro

Osteoporosi maschile e anafilassi da imenotteri
Male osteoporosis and hymenoptera venom anaphylaxis
<p>Mastocytosis is one of the rare causes of unexplained&nbsp;osteoporosis, above all in males. On the other hand, a strict association between severe systemic reactions after&nbsp;hymenoptera sting and mastocytosis was recently demonstrated. Here we report a case of unexplained severe&nbsp;osteoporosis with multiple vertebral fractures in a 48 years old male, which also suffered an anaphylactic reaction after&nbsp;hymenoptera sting. Among laboratory tests performed to clarify the cause of osteoporosis, serum tryptase&nbsp;concentrations were determined. The value of tryptase was 43.6 &mu;g/L, four times higher than the upper reference limit.&nbsp;Skin did not show abnormalities; bone marrow vertebral biopsy was not valuable, but bone marrow aspirate from iliac&nbsp;crest demonstrated the presence of atypical mast cells expressing CD25; D816V mutation of KIT gene was also&nbsp;identified. These findings, in association with an increase of serum tryptase concentrations, fulfil all minor criteria&nbsp;requested for the diagnosis of systemic mastocytosis. Osteoporosis treatment with zolendronate and vitamin D&nbsp;supplementation was started, but later, for the persistence of bone pain, therapy with -interferon was added. This case&nbsp;confirms that an unexplained osteoporosis, especially if associated with hymenoptera sting systemic reaction, requires&nbsp;exclusion of a systemic mastocytosis.</p>
Biochimica Clinica ; 38(4) 347-349
Casi clinici - Case report