Lab tests for Pagets Disease of Bone
Which laboratory tests should be obtained to evaluate and monitor Pagets Disease of Bone?
ALP, calcium, albumin, liver function tests, and 25-hydroxyvitamin D should be obtained in patients with suspected or known PDB. ALP can be within normal limits in those with limited, monostotic disease or during the initial osteolytic phase of PDB, but rises during the osteoblastic phase and can correlate with disease activity. Measurement of ALP is the preferred assay in PDB. If liver disease is present or ALP is normal, other markers of bone formation (osteoblastic activity) such as bone-specific alkaline phosphatase (BSAP) or procollagen type I N-terminal propeptide (P1NP) can be checked. The elevated turnover marker can be followed over time every 6 to 12 months to assess a patient’s response to treatment and/or PDB activity.