WEDNESDAY, Oct. 7 (HealthDay News) -- A case of osteoporosis with high bone turnover in a relatively young man with celiac disease suggests a possible role for autoantibodies against osteoprotegerin in osteoporosis in patients with this condition, according to research published in the Oct. 8 issue of the New England Journal of Medicine.
Philip L. Riches, of the University of Edinburgh in the United Kingdom, and colleagues report on the case of a 40-year-old man presenting with a low-trauma clavicle fracture. The patient was found to have subclinical celiac disease and autoimmune hypothyroidism, in addition to high-turnover osteoporosis.
The researchers found that the patient had circulating autoantibodies against osteoprotegerin, which is produced by osteoblasts and inhibits bone resorption. Autoantibodies against osteoprotegerin were also found in three of 15 patients with celiac disease, but not in 10 healthy controls or 14 patients with autoimmune hypothyroidism. The elevated bone turnover was the primary cause of osteoporosis in this patient, and, the authors note, the condition appeared to be due to the neutralizing autoantibodies against osteoprotegerin.
Observations from the study "suggest that osteoprotegerin autoantibodies may contribute to the pathogenesis of osteoporosis in celiac disease more widely, but the observations should be interpreted with caution, since bone mineral density is a complex trait influenced by many genetic and environmental factors," Riches and colleagues conclude.
Several authors reported relationships with pharmaceutical companies and/or patent applications involving osteoprotegerin antibodies for a diagnostic test and therapeutic target.
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