JSWMC

Background: Paget’s disease of bone is a chronic disorder characterized by abnormal bone remodeling, often leading to structurally compromised bones. Although it can be asymptomatic, involvement of the skull and other bones can cause significant complications. This case report presents a postmenopausal woman with Paget’s disease, complicated by iron deficiency anemia and secondary hyperparathyroidism due to vitamin D deficiency. Case Presentation: A 56-year-old woman with a 12-year history of asthma and hypertension presented with vertigo, a recent fall, and mild headaches. Examination revealed notable cranial deformities and scalp vein dilation. Investigations showed severe microcytic hypochromic anemia, elevated parathyroid hormone, low vitamin D, and high alkaline phosphatase levels. Imaging confirmed extensive Paget’s disease affecting the skull and other bones. She was treated for iron deficiency anemia and vitamin D deficiency and received bisphosphonate therapy with intravenous zoledronic acid. Over five years, her biochemical markers normalized, though physical and radiological improvements were minimal. Conclusion: This case highlights the importance of early diagnosis and long-term management of Paget’s disease, particularly when complicated by metabolic disturbances. Comprehensive treatment, including vitamin D supplementation and bisphosphonates, can lead to significant biochemical improvement, although physical changes may persist. Compliance with treatment and regular follow-ups are crucial for successful disease management.