A case of elevated P1NP levels: uncovering Paget's disease in a postmenopausal woman

Abstract

INTRODUCTION: Procollagen type 1 N-terminal propeptide (P1NP) is a marker of bone formation that is frequently used in the diagnosis and management of osteoporosis. Elevated levels of P1NP may indicate increased bone turnover, which can be a sign of various bone disorders. Paget’s disease of bone is a chronic disorder characterized by excessive and disorganized bone remodeling. The exact cause of Paget’s disease is unknown, but it is thought to be related to genetic factors and viral infections.CASE REPORT: A 48-year-old postmenopausal woman presented with a six-month history of low back pain. Her DEXA scan showed osteopenia in the lumbar spine, and her serum P1NP level was markedly elevated. Further workup revealed a diagnosis of Paget’s disease of bone. The patient was treated with bisphosphonates, resulting in significant improvement in her symptoms and normalization of her P1NP level.CONCLUSIONS: This case highlights the importance of considering Paget’s disease as a potential cause of elevated P1NP levels. The use of bisphosphonates can be effective in treating Paget’s disease and improving bone health. Elevated P1NP levels can be seen in various bone disorders, and clinicians should be aware of its potential clinical implications. The measurement of P1NP is routinely included in the workup of patients with suspected bone disorders, and its levels are used to monitor response to treatment.