Bone matrix hypermineralization associated with low bone turnover in a case of Nasu-Hakola disease

Mohammad Shboul, Paul Roschger, Rudolf Ganger, Lefteris Paschalis, Stamatia Rokidi, Shahin Zandieh, Jana Behunova, Christian Muschitz, Astrid Fahrleitner-Pammer, Alvin Yu Jin Ng, Sumanty Tohari, Byrappa Venkatesh, Carine Bonnard, Bruno Reversade, Klaus Klaushofer, Ali Al Kaissi

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Analysis of tissue from a 34-years-old male patient from Austrian origin with a history of multiple fractures associated with painful episodes over the carpal, tarsal and at the end of the long bones respectively is presented. Radiographic images and axial 3DCT scans showed widespread defects in trabecular bone architecture and ill-defined cortices over these skeletal sites in the form of discrete cystic-like lesions. Family history indicated two sisters (one half and one full biological sisters) also with a history of fractures. Whole exome sequencing revealed two heterozygous missense mutations in TYROBP (MIM 604142; NM_003332.3) gene encoding for a cell-surface adaptor protein, which is part of a signaling complex triggering activation of immune responses. It is expressed in cells of the ectoderm cell linage such as NK and dendritic cells, macrophages, monocytes, myeloid cells, microglia cells and osteoclasts. The phenotype and genotype of the patient were consistent with the diagnosis of Nasu-Hakola disease (NHD) (OMIM 221770). Investigations at the bone material level of a transiliac bone biopsy sample from the patient using polarized light microscopy and backscatter electron imaging revealed disordered lamellar collagen fibril arrangement and extensively increased matrix mineralization. These findings are the first bone material data in a patient with NHD and point toward an osteoclast defect involvement in this genetic condition.
Original languageEnglish (US)
Pages (from-to)48-55
Number of pages8
StatePublished - Jun 1 2019
Externally publishedYes

Bibliographical note

Generated from Scopus record by KAUST IRTS on 2023-02-15

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Histology
  • Physiology


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