Presence of pyrophosphate in bone from an atypical femoral fracture site

Long-term antiresorptives use has been linked to atypical subtrochanteric and diaphyseal femoral fractures (AFF), the pathogenesis of which is still unknown. In the present case report we present the results of analysis of bone chips from a 74-year old female patient that had been on alendronate, ib...

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Bibliographic Details
Authors: Shabestari, Maziar, Eriksen, Erik Fink, Paschalis, Eleftherios P., Roschger, Paul, Gamsjaeger, Sonja, Klaushofer, Klaus, Berzlanovich, Andrea, Nogués Solán, Xavier|||0000-0002-5537-1859, Puig-Verdié, Lluís|||0000-0002-4432-9452, Díez Pérez, Adolfo|||0000-0001-8162-0209
Format: article
Publication Date:2017
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:186198
Online Access:https://ddd.uab.cat/record/186198
https://dx.doi.org/urn:doi:10.1016/j.bonr.2017.02.006
Access Level:Open access
Keyword:Atypical femoral fracture
Pyrophosphate
Description
Summary:Long-term antiresorptives use has been linked to atypical subtrochanteric and diaphyseal femoral fractures (AFF), the pathogenesis of which is still unknown. In the present case report we present the results of analysis of bone chips from a 74-year old female patient that had been on alendronate, ibandronate and denosumab treatment, and who sustained an atypical femoral fracture, by histology, quantitative backscattered electron imaging, and Raman spectroscopic analysis. The results indicate ongoing osteoclastic resorption, but also several abnormalities: 1) an altered arrangement of osteons; 2) impaired mineralization; 3) the presence of pyrophosphate, which might contribute to the impaired mineralization evident in the present case. Taken together, these changes may contribute to the focally reduced bone strength of this patient.