{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T08:13:52Z","timestamp":1770884032814,"version":"3.50.1"},"reference-count":11,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Indolent systemic mastocytosis (ISM) is a rare clonal disorder characterized by mast cell proliferation and release of inflammatory mediators affecting multiple organs, including the skeleton, frequently causing osteoporosis. We present the case of a 78-year-old woman with a longstanding history of cutaneous mastocytosis who developed systemic symptoms including gastrointestinal discomfort and flushing. Laboratory evaluation revealed elevated serum tryptase level of 28.7\u2005ng\/mL (SI: 28.7\u2005\u03bcg\/L) (reference range, &amp;lt;11\u2005ng\/mL [SI: &amp;lt; 11\u2005\u03bcg\/L]), a positive KIT D816V pathogenic variant (testing to confirm somatic vs germline origin was not available), and increased urinary prostaglandin D2. Bone marrow biopsy confirmed ISM. Despite long-term bisphosphonate therapy, she sustained a low-trauma vertebral fracture, prompting transition to denosumab in 2021. Over 3 years of treatment, the patient experienced a 7% increase in lumbar spine bone mineral density and a sustained decrease in serum tryptase levels to 12.0 to 14.3\u2005ng\/mL (SI: 12.0-14.3\u2005\u03bcg\/L), suggesting improved bone health and potential reduction in systemic mast cell burden. This case highlights the challenges in managing ISM-related osteoporosis and suggests a dual benefit of denosumab in improving bone mineral density and potentially reducing mast cell activity.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf272","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T12:24:50Z","timestamp":1761222290000},"source":"Crossref","is-referenced-by-count":1,"title":["Denosumab as a Potential Disease-Modifying Treatment in Indolent Systemic Mastocytosis-Related Osteoporosis"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4578-7081","authenticated-orcid":false,"given":"Mohammed","family":"Abbas","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Griffin Health\/Hospital , Derby, CT 06418 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