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Editor-in-chief
Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada

Publisher
Biomedia srl
Via L. Temolo 4, 20126 Milano

Responsible Editor
Giuseppe Agosta

Editorial Secretary
Andrea di Bello
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282
email: biochimica.clinica@sibioc.it

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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da P. Bonadonna

Osteoporosi maschile e anafilassi da imenotteri
Male osteoporosis and hymenoptera venom anaphylaxis
R. Zanotti \| P. Bonadonna \| A. Artuso \| G. Tripi \| C. Lombardo \| B. Caruso \| S. Giannini \| L. Pavan \| M.A. Crivellaro \| M. Rossini \|
<p>Mastocytosis is one of the rare causes of unexplained osteoporosis, above all in males. On the other hand, a strict association between severe systemic reactions after hymenoptera sting and mastocytosis was recently demonstrated. Here we report a case of unexplained severe osteoporosis with multiple vertebral fractures in a 48 years old male, which also suffered an anaphylactic reaction after hymenoptera sting. Among laboratory tests performed to clarify the cause of osteoporosis, serum tryptase concentrations were determined. The value of tryptase was 43.6 μg/L, four times higher than the upper reference limit. Skin did not show abnormalities; bone marrow vertebral biopsy was not valuable, but bone marrow aspirate from iliac crest demonstrated the presence of atypical mast cells expressing CD25; D816V mutation of KIT gene was also identified. These findings, in association with an increase of serum tryptase concentrations, fulfil all minor criteria requested for the diagnosis of systemic mastocytosis. Osteoporosis treatment with zolendronate and vitamin D supplementation was started, but later, for the persistence of bone pain, therapy with -interferon was added. This case confirms that an unexplained osteoporosis, especially if associated with hymenoptera sting systemic reaction, requires exclusion of a systemic mastocytosis.</p>
Biochimica Clinica ; 38(4) 347-349 Casi clinici - Case report

La mastocitosi sistemica: un approccio multidiscliplinare
Systemic mastocytosis: a muldisciplinary approach
R. Zanotti \| P. Bonadonna \| M. Bonifacio \| B. Caruso \| C. Colato \| G. De Matteis \| O. Perbellini \| M. Rossini \| C. Sabbadini \| D. Schena \| M. Tebaldi \| A. Zamò \|
<p>Systemic mastocytosis (SM) is a clonal disorder with complex manifestations determined by the proliferation and accumulation of mast cells in various organs (mainly in skin and bone marrow) and by the release of soluble mediators. Indolent SM is the more frequent variant of the disease, but its actual prevalence is unknown as the majority of patients suffering from SM are misdiagnosed, particularly when skin lesions are absent. Anaphylactic reactions to Hymenoptera (and less frequently to drugs or foods), idiopatic anaphylaxis, unexplained osteoporosis, or unexplained gastrointestinal symptoms are common manifestations of SM in absence of skin involvement. Therefore, the diagnosis and management of patients with SM require a multidisciplinary approach, which encompasses hematological, allergological, dermatological, rheumatological, and gastroenterological evaluations. A correct and timely diagnosis is required for: a) adequate counseling of patients and their physicians; b) beginning of symptomatic treatment (antimediator therapy); c) prevention of more severe manifestations of the disease (i.e., recurrent anaphylaxis, osteoporosis, bone fractures). In this paper, the epidemiology, classification, diagnostic tools, clinical manifestations, and therapy of SM are reviewed and a guidance on multidisciplinary approach to SM is provided.</p>
Biochimica Clinica ; 36(3) 158-170 Rassegna - Reviews