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Updated: Jun 22, 2026
06:17
Osteoclast Derivation from Mouse Bone Marrow
Published on: November 6, 2014
Giant osteoclasts after long-term bisphosphonate therapy: diagnostic challenges
Nidhi Jain1, Robert S Weinstein
1Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, Department of Internal Medicine, Central Arkansas Veterans Healthcare System, University of Arkansas for Medical Sciences, Little Rock, AR 72205-7199, USA.
Nature Reviews. Rheumatology
|June 4, 2009
Summary
Long-term aminobisphosphonate therapy can cause giant osteoclasts in osteoporosis patients. These findings, though alarming, are typically benign and resolve with continued treatment.
Area of Science:
- Endocrinology
- Histopathology
- Bone Biology
Background:
- A 55-year-old woman with osteoporosis, treated with aminobisphosphonates for 4 years, presented with a vertebral fracture.
- Bone biopsy revealed numerous giant osteoclasts (>40 nuclear profiles).
Observation:
- Histological examination showed detached, apoptotic giant osteoclasts.
- Low-to-normal osteoid and osteoblast levels were observed.
- Marrow stroma appeared normal, with no signs of malignancy.
Findings:
- The observed giant osteoclasts are characteristic of long-term aminobisphosphonate therapy.
- These histological findings are not detrimental to bone health.
- The patient's condition improved after reinstituting aminobisphosphonate treatment.
Implications:
- This case highlights the benign nature of giant osteoclasts in patients on long-term bisphosphonate therapy.
- It emphasizes the importance of accurate histological interpretation to avoid misdiagnosis.
- Continued aminobisphosphonate treatment can lead to asymptomatic recovery.
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