Retinoid-induced ossification of the posterior longitudinal ligament

Pennes, David R.; Martel, William; Ellis, Charles N.

doi:10.1007/bf00355561

Cited by 33 publications

(9 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The literature has been conflicting. Soineeentres repori development of skeletal hyperostosis due to oral retinoids (1)(2)(3)(4)(5)(6). Other investigators do not report radiographic changes during either short-term retinoid therapy (7) or prolonged treatment in adults (8).…”

Section: Sirmentioning

confidence: 99%

See 1 more Smart Citation

Bamboo Spine Mimicking Bekhterev's Disease Caused by Long-term Acitretin Treatment

Mørk¹,

Austad²,

Kolbenstvedt³

2006

Acta Derm Venereol

View full text Add to dashboard Cite

Sir.During the last 20 years several papers have been published regarding the skeletal toxicity of long-term retinoid therapy. The literature has been conflicting. Soineeentres repori development of skeletal hyperostosis due to oral retinoids (1-6). Other investigators do not report radiographic changes during either short-term retinoid therapy (7) or prolonged treatment in adults (8). Osteoporosis caused by acitretin (9, 10) has also been discussed. We here report on 3 patients with lamellar iehthyosis who have been treated with acitretin lor several years and developed spinal hyperostoses. CASE REPORTSPatient 1 is a 60-year-old woman with lamellar iehthyosis. She was given etretinate 0.75 tng/kg/day from 1979 and later switehed to aeilretin 0.5 tng/kg/day continuously, and she is still using this medication. In 2001 she complained of increased stiffness in her spine and lower back pain. X-ray examination ofthe spine showed extensive hyperostosis-like bamboo spine and initially the diagnosis of Bckhterev's disease (spondylitis ankylopoetica) was suspected. However, X-ray of her iliosaeral joints was normal and she was HLA B27 negative. The diagnosis of Bekhtcrev's disease was therefore ruled out by her rheumatologist.Patient 2 is a 69-year-old man with lamellar iehthyosis. He has used retinoids approximately 0.5 mg/kg/day continuously since I97S. During the last years he has complained of lower baek pain and increased stiffness of his spine. X-ray examination showed extensive hyperostosis-like batnboo spine. His iliosaeral joints were radiographically normal and he was HLA B27 negative.Patient 3 is a 45-year-old wotnan with lamellar iehthyosis. Since 1978 she has used etretinate 0.7 mg/kg/day and, from 1992, acitretin 0.5 mg/kg/day continuously. She experienced increased stiffness of her spine since 2001 and X-ray examination showed hyperostosis-like bamboo spine (Fig. I). She was HLA B27 negative and her iliosaeral joints were normal. DISCUSSIONDifferent dermatologieal centres monitor patients on long-term retinoid therapy differently regarding bone toxieity. Sotne centres do not make X-ray skeletal investigations, while others do. Interestingly several Fig. /, Conventional X-ray imjigeoflumharspincuuinlero-posteriorprojeetion in patieni 3. Syndesmopiiyles similar to those seen in Hekliterev's disease lateral to the intervcrlehral discs {arrows).centres have not detected hyperostosis in their patients on long-term retinoid therapy. Whether this is explained by the lack of skeletal monitoring or genetic differences between groups of patients is not known. In our departtnent we have, during the last 20 years, routinely perfortned X-ray surveys ofthe skeleton at baseline and every second year in patients on long-term retinoid treattnent. We experienced two clearly abnortnal calcifieations (5) in the forearm ofa patient with X-Iinked recessive iehthyosis and a latnlnar hyperostotic process in the forearm in a 66-year old woman with pustulosis palmoplantaris.In our previous study (5) radiographs ofthe spine were of ...

show abstract

Section: Sirmentioning

confidence: 99%

“…Cutaneous adverse events to leuprorelin acetate are rare, but several cases of local reactions at the itijection sites have been reported in urology or paediatric journals (1)(2)(3)(4)(5). These reactions have been described as erythematous ma-cules, infiltrated plaques, subcutaneous nodules and sterile abscesses.…”

Section: Sinmentioning

confidence: 99%

Bamboo Spine Mimicking Bekhterev's Disease Caused by Long-term Acitretin Treatment

Mørk¹,

Austad²,

Kolbenstvedt³

2006

Acta Derm Venereol

View full text Add to dashboard Cite

show abstract

“…in hypervitaminosis A [19] and during retinoid therapy [17]. A biochemical mechanism is unlikely in the tetanus patients.…”

Section: Discussionmentioning

confidence: 98%

Hyperostosis and osteoarthritis in patients surviving after tetanus

1994

View full text Add to dashboard Cite

Twenty patients (12 men and 8 women) who had survived tetanus were examined for bone and joint abnormalities, 1-9 years after the disease. The radiographic findings in the elbows were abnormal in 13 out of 20 patients, as were the shoulders of all 3 patients examined. Insertion hyperostoses were found at the elbow and/or in the shoulder region in 5 (25%) of the patients. The hyperostoses were bilateral in 3 patients. One of the patients with hyperostoses also had calcifications in the soft tissue of the elbow. The abnormalities were associated with mild clinical symptoms. Trauma to the periosteum caused by repeated traction of muscular contractions is possibly the causative mechanism. Twelve patients (60%) had osteoarthritis of the elbow joint presumably secondary to the violent stress to the joint.

show abstract

“…In this report, RXR β adjacent to COL11A2 , was investigated for its potential involvement in OPLL. OPLL occurrence has been frequently observed in patients with dermal disorders who had been treated by the long‐term administration of vitamin A (9) . An increase in the prevalence of diffuse idiopathic skeletal hyperostosis, a related disorder to OPLL, has been reported in vitamin A–treated patients (8,23) .…”

Section: Discussionmentioning

confidence: 99%

“…Evidently RXR β was also considered to be a candidate for OPLL, because of its chromosomal localization and possible involvement in bone formation. Several reports have discussed the relationship between vitamin A administration and hyperostosis (8‐10) . To test the hypothesis that RXR β constitutes the genetic susceptibility of OPLL, first we determined the genomic organization of the gene followed by the genetic screening of the gene.…”

Section: Introductionmentioning

confidence: 99%

Human Retinoic X Receptor β: Complete Genomic Sequence and Mutation Search for Ossification of Posterior Longitudinal Ligament of the Spine

Numasawa

Koga

Ueyama

et al. 1999

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Ossification of the posterior longitudinal ligament of the spine (OPLL) is characterized by ectopic bone formation in the ligament. OPLL is a very common disorder, in fact it constitutes the leading cause of myelopathy among Japanese. In the previous report, we provided the genetic linkage evidence that the genetic susceptibility of OPLL mapped to HLA complex of chromosome 6. As a candidate gene approach, retinoic X receptor ␤ (RXR␤), assigned to chromosome 6p21.3 adjacent to HLA class II, was analyzed for a possible causality. To start screening for the molecular variants of RXR␤ in OPLL subjects, we first obtained P1 phage genomic clones containing the entire human RXR␤ and elucidated the genomic organization of the gene. The human RXR␤ is composed of 10 exons spanning over 6.2 kb of genomic DNA. Sequence analysis of the promoter region revealed a GC-rich sequence without TATA motif. We have identified three distinct molecular variants, one was in exon 10 and two were in the intergenic region between RXR␤ and collagen 11A2 (COL11A2). Two variants in the intergenic region, 3 end + 140 and 3 end + 561, exhibit statistically significant associations with OPLL in case-control study (p = 0.0028 for 3 end + 140 and p = 0.034 for 3 end + 561). These results indicate that the genetic causality of OPLL lies within or close to the RXR␤/COL11A2 locus. (J Bone Miner Res 1999;14:500-508)

show abstract

Retinoid-induced ossification of the posterior longitudinal ligament

Cited by 33 publications

References 10 publications

Bamboo Spine Mimicking Bekhterev's Disease Caused by Long-term Acitretin Treatment

Bamboo Spine Mimicking Bekhterev's Disease Caused by Long-term Acitretin Treatment

Hyperostosis and osteoarthritis in patients surviving after tetanus

Human Retinoic X Receptor β: Complete Genomic Sequence and Mutation Search for Ossification of Posterior Longitudinal Ligament of the Spine

Contact Info

Product

Resources

About