Skip to main content

Advertisement

Log in

Hepatitis C-associated osteosclerosis (HCAO): report of a new case with involvement of the OPG/RANKL system

  • Case Report
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

We report a new case of hepatitis C-associated osteosclerosis (HCAO). The clinical presentation of the patient was an acquired deep severe bone pain with increased serum bone alkaline phosphatase activity (up to 12 times the upper limit of normal), and generalized bone sclerosis, temporally related to the hepatitis C-virus (HCV) infection. We documented in this patient an increase of circulating osteoprotegerin (OPG), and a concentration of circulating receptor activator for nuclear factor-kB ligand (RANKL) below the lower limit of the reference range. The observed abnormalities of the OPG/RANKL system may contribute to the maintenance of the positive balance of bone remodeling that characterizes patients with HCAO.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1 A
Fig. 2

Similar content being viewed by others

References

  1. Choo QL, Weiner AJ, Overby LR (1990) Hepatitis C virus: the major causative agent of viral non-A, non-B hepatitis. Br Med Bull 46:423-441

    CAS  PubMed  Google Scholar 

  2. Villareal DT, Murphy WA, Teitelbaum SL, Arens MQ, Whyte MP (1992) Painful diffuse osteosclerosis after intravenous drug abuse. Am J Med 93:371–381

    CAS  PubMed  Google Scholar 

  3. Beyer HS, Anderson Q, Shih MS, Parfitt AM, Heath H (1993) Diffuse osteosclerosis in intravenous drug abusers. Am J Med 95:660–661

    Article  CAS  PubMed  Google Scholar 

  4. Whyte MP, Teitelbaum SL, Reinus WR (1996) Doubling skeletal mass during adult life: the syndrome of diffuse osteosclerosis after intravenous drug abuse. J Bone Miner Res 11:554–558

    CAS  PubMed  Google Scholar 

  5. Diamond T, Depczysnki B (1996) Acquired osteosclerosis associated with intravenous drug use and hepatitis C infection. Bone 19:679–683

    Article  CAS  PubMed  Google Scholar 

  6. Whyte MP, Reasner CA (1997) Hepatitis C-associated osteosclerosis after blood transfusion. Am J Med 102:219–229

    Article  CAS  PubMed  Google Scholar 

  7. Hassoun AAK, Nippoldt TB, Tiegs RD, Khosla S (1997) Hepatitis C-associated osteosclerosis: an unusual syndrome of acquired osteosclerosis in adults. Am J Med 103:70–73

    CAS  Google Scholar 

  8. Shaker JL, Reims WR, Whyte MP (1998) Hepatitis C-associated osteosclerosis: late onset after blood transfusion in an elderly woman. J Clin Endocrinol Metab 83:93–98

    Article  CAS  PubMed  Google Scholar 

  9. Wakitani S, Hattori T, Nakaya H, Chae YM, Murata N, Tanigami A (2003) Clinical images: hepatitis C-associated osteosclerosis. Arthritis Rheum 48:268

    Article  PubMed  Google Scholar 

  10. Khosla S, Hassoun AAK, Baker BK, Liu F, Zein NN, Whyte MP, Reasner CA, Nippoldt TB, Tiegs RD, Hintz RL (1998) Insulin-like growth factor system abnormalities in hepatitis C-associated osteosclerosis. J Clin Invest 101:2165–2173

    CAS  PubMed  Google Scholar 

  11. Khosla S, Ballard FJ, Conover CA (2002) Use of site-specific antibodies to characterize the circulating form of big insulin-like growth factor II in patients with hepatitis C-associated osteosclerosis. J Clin Endocrinol Metab 87:3867–3870

    CAS  PubMed  Google Scholar 

  12. Khosla S (2001) Minireview: the OPG/RANK/RANKL system. Endocrinology 142:5050–5055

    Article  CAS  PubMed  Google Scholar 

  13. Shaker JL, Moore BP, Whyte MP (1999) Hyperparathyroidism and increased serum IGF-binding protein-2 levels in hepatitis C-associated osteosclerosis. J Clin Endocrinol Metab 84:384–385

    Article  CAS  PubMed  Google Scholar 

  14. Whyte MP, Chines A, Silva DP, Landt Y, Ladenson JH (1996) Creatine kinase brain isoenzyme (BB-CK) presence in serum distinguishes osteopetroses among the sclerosing bone disorders. J Bone Miner Res 11:1438–1443

    CAS  PubMed  Google Scholar 

  15. Pennisi P, Signorelli SS, Riccobene S, Celotta G, Di Pino L, La Malfa T, Fiore CE (2004) Low bone density and abnormal bone turnover in patients with atherosclerosis of peripheral vessels. Osteoporos Int 15:389–395

    Article  CAS  PubMed  Google Scholar 

  16. Szalay F, Hegedus D, Lakatos PL, Tornai I, Bajnock E, Dunkel K, Lakatos P (2003) High serum osteoprotegerin and low RANKL in primary biliary cirrhosis. J Hepatol 38:395–400

    CAS  PubMed  Google Scholar 

  17. Burgess TL, Qian YX, Kaufman S, Ring BD, Van G, Capparelli C (1999) The ligand for osteoprotegerin (OPGL) directly activates mature osteoclasts. J Cell Biol 145:527–538

    Article  CAS  PubMed  Google Scholar 

  18. Bekker PJ, Holloway DL, Rasmussen AS, Murphy R, Martin SW, Leese PT, Holmes GB, Dunstan CR, DePaoli AM (2004) A single-dose placebo-controlled study of AMG 162, a fully human monoclonal antibody to RANKL, in postmenopausal women. J Bone Miner Res 19:1059–1066

    CAS  PubMed  Google Scholar 

  19. Tappero G, Farina M, Negro F, Anfossi G, Mattiello L, Giuli PD, Colombatto P, Brunetto MR, Angeli A, Bonino F (1997) Intrahepatic expression of c-fos, c-myb and c-myc oncogenes: correlation with virus-induced chronic liver disease and response to interferon. Ital J Gastroenterol Hepatol 29:148–154

    CAS  PubMed  Google Scholar 

  20. Sabatakos G, Sims NA, Chen K, Aoki K, Kelz MB, Amling M, Bouali V, Mukhopadhyay K, Ford K, Nestler EJ, Baron R (2000) Overexpression of ΔFos B transcription factor(s) increases bone formation and inhibits adipogenesis. Nat Med 6:985–990

    Article  CAS  PubMed  Google Scholar 

  21. Jochum W, David JP, Elliot C, Wutz A, Plenk H, Matsuo K, Wagner EF (2000) Increased bone formation and osteosclerosis in mice overexpressing the transcription factor Fra-1. Nat Med 6:980–984

    Article  CAS  PubMed  Google Scholar 

  22. Matsuo K, Owens JM, Tonko M, Elliot C, Chambers TJ, Wagner EF (2000) Fos-1 is a transcriptional target of c-Fos during osteoclast differentiation. Nat Genet 24:184–187

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. E. Fiore.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fiore, C.E., Riccobene, S., Mangiafico, R. et al. Hepatitis C-associated osteosclerosis (HCAO): report of a new case with involvement of the OPG/RANKL system. Osteoporos Int 16, 2180–2184 (2005). https://doi.org/10.1007/s00198-005-1858-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-005-1858-8

Keywords

Navigation