LAUSR

Background Hyperuricemia and gout has been described as metabolic complications in patients with more extensive Paget’s disease, with a very variable prevalence. However, there is no data about fluctuations of uric acid levels asociated with its treatment and its correlation with alkaline phosphatase variations during gout attacks. Objectives To analyze the frequency of hyperuricemia and gout in patients with a diagnosis of Paget’s disease of bone (PD) and to establish the correlation between the activity of Paget’s disease and its treatment in the fluctuations of uric acid levels. Methods Patients with Paget’s disease and with scintigraphic uptake suggestive of activity were included. A database was created including demographic information, the presence of symptoms associated with PD, its type (monostotic or polyostotic), alkaline phosphatase (AP) and uric acid (UA) levels at diagnosis and the treatment received. AP and UA levels after treatment were also collected as well as the presence of possible hyperuricemic risk factors (HRF), history of gout and levels of AP and UA during gout attacks, if any. Finally data was analyzed using SPSS v21. Results A total of 95 patients were included with a mean age of 70.59 years (range 45-89), with 56% of them being women. The mean values of AP and UA at diagnosis were 178.05± 82.81 mg/dL and 5.84±1.74 mg/dL respectively. 58.9% of the patients had monostotic involvement (56/95) and only 53.12% had associated symptoms (51/95), whereas in the rest of the patients PD was an incidental finding. 70.83% did not present HRF and 56 patients (58.9%) had received treatment for their PD (41% of them with zoledronic acid). Pearson correlation between PA and UA levels was found moderatly positive (0.710 with p<0.0005) and 50.52% of the patients (48/95) had UA levels above 6mg/dL at the time of diagnosis, with a mean of 7.10 mg/dl ±1.74. In 93.5% of the cases there was a decrease in UA levels after the treatment for PD, with a mean decrease of 0.78±1.3 mg/dL over the baseline value at one year of follow-up. Only 11.57% of the patients in our cohort presented gout symptoms during their follow-up, with an increase in AP levels at the time of the attack in 63.63% of the cases. Conclusion In our cohort, there was a moderate positive correlation between the elevation of AP and UA in patients with active Paget’s disease. Treatment for PD produced a decrease in UA levels from baseline in most patients. Similarly, during gout attacks, an increase in AP levels could be. Reference [1] Lluberas-Acosta G, Hansell JR, Schumacher HR Jr. Paget’s disease of bone in patients with gout. Arch Intern Med1986Dec; 146 (12):2389-92. Disclosure of Interests None declared