French national reference center for constitutional bone diseases (MOC)
The reference center for constitutional bone diseases (MOC) at Cochin hospital is a multidisciplinary center of specialists in adult bone pathologies: rheumatologists, rehabilitation physicians, orthopedic surgeons, osteoarticular radiologists.
It thus brings together several specialists with a long habit of working together, for difficult patients, in the frequent context of a recourse activity.
This activity is facilitated by geographic coherence: a surgery building and a rheumatology building linked by the basement, bringing together rehabilitation and osteoarticular radiology.
The center can call :
- on teams from specialized services : dieticians, physiotherapists, social workers, clinical research assistants.
- on other specialists in the hospital : pain center, endocrinologists.
This reference center is affiliated with the OSCAR (bone, calcium and cartilage) rare disease healthcare network and the BOND European reference network (ERN) for rare bone disorders.
Keywords : Osteogenesis imperfecta, Multiple osteochondromas, Fibrous dysplasia of bone, Cleidocranial dysplasia, Ollier disease, Hypophosphatasia, Strensiq, Idiopathic juvenile osteoporosis, Hajdu-Cheney syndrome, Fibrodysplasia ossificans progressiva.
Medical team
Head of the reference center
Pr Christian Roux
MD, PhD
Dr Eugénie Koumakis
MD, PhD
Contact us
Phone. +33 (0)1 58 41 25 78
If you contact us by email, please specify your full contact details as well as the reason for the request.
In case of emergency
The missions of the reference center for constitutional bone diseases (MOC) are :
- to manage patients with constitutional bone disease followed before adulthood in the pediatric departments of the Necker and Trousseau MOC reference centers
- to manage patients not diagnosed in childhood
- to be a center for innovative therapeutic, non-pharmacological and pharmacological proposals
- to be a center of recourse and expertise for physicians faced with difficult patients
- to provide transitional counseling for young adults
The international classification lists 461 constitutional bone diseases (Mortier GR, Cohn DH, Cormier-Daire V et al, Nosology and Classification of Genetic Skeletal Disorders: 2019 Revision; Am J Med Gen A, 2019, 179 (12) : 2393-2419).
To date, the main ones are :
Bone fragilities :
Anarchic bone development :
Metaphyseal dysplasias
- Cartilage-hair hypoplasia
- Spondylometaphyseal dysplasia, Schmidt type
- Metaphyseal chondrodysplasia, Spahr type
- Metaphyseal chondrodysplasia, Jansen type
Multiple epiphyseal dysplasia (or poly-epiphyseal)
Spondyloepi(-meta)physary dysplasias
- Type 2 collagen-related bone disorder
- Type 11 collagen-related bone disorder
- Pseudoachondroplasia
- Metatropic dysplasia
- Brachyolmia
- Spondyloepiphyseal dysplasia tarda
Acromelic dysplasias
- Acromicric dysplasia
- Geleophysic dysplasia
- Myhre syndrome
- Acrodysostosis
- Weill-Marchesani syndrome
- Trichorhinophalangeal syndrome type 2
- Trichorhinophalangeal syndrome type 1 and 3
Acromesomelias and mesomelias :
Short stature with rhizomelia :
Bone condensation, osteosclerosis :
- Osteopetrosis and related disorders
- Pycnodysostosis
- Camurati-Englemann disease
- Craniometaphyseal dysplasia
- Ghosal hematodiaphyseal dysplasia syndrome
Multiple dislocations :
- Larsen syndrome
- Desbuquois syndrome
- Spondyloepimetaphyseal dysplasia with joint laxity
- Diastrophic dwarfism
Long bones curvature :
Spondylodysplastic dysplasia :
Osteolysis :
- Torg-Winchester syndrome
- Nodulosis-arthropathy-osteolysis syndrome
- Hajdu-Cheney syndrome
- Gorham-Stout disease
- MIRRA
Cranial, costovertebral, patellar, extremity dysostoses :
- Crouzon disease
- Saethre-Chotzen syndrome
- Apert syndrome
- Jarcho-Levin syndrome
- Isolated Klippel-Feil syndrome
- Adams-Oliver syndrome
- Poland syndrome
Metabolic diseases with predominant skeletal expression :
- Pr Christian Roux – Rheumatologist, head of the reference center
- Pr Karine Briot – Rheumatologist
- Dr Eugénie Koumakis – Rheumatologist
- Dr Julia Herrou – Rheumatologist
- Pr Serge Perrot – Rheumatologist
- Pr Philippe Anract – Orthopedic surgeon
- Dr Frédéric Sailhan – Orthopedic surgeon
- Cathie Lacazette – Medical secretary
- Sibi Atayi – Medical secretary
- Mioranirainy Deraharijaona – Clinical research associate
- Workshop: Osteogenesis imperfecta in adults in 2016
Contact: Eugénie Koumakis
Location: Cochin hospital - Workshop: Osteogenesis imperfecta in transition, Necker-Cochin coordination
Contact: Dr Baujat
Location: Necker hospital
In development
- Hypophosphatasia Webinar on April 15, 2021
Contact: Pr Karine Briot
Location: Cochin hospital
The National Diagnostic and Care Protocols (PNDS in french) are best practice guidelines for rare diseases. The objective of a PNDS is to explain to the professionals concerned the optimal diagnostic and therapeutic management and the care pathway for a patient suffering from a given rare disease.
As provided for in the 2011-2014 second national plan for rare diseases , they are developed by the rare diseases reference and competence centers using a method proposed by the Haute Autorité de Santé (HAS).
The PNDS include a “summary for the attending physician” section.
- Nail-Patella syndrome (2020)
- Non-vascular Ehlers-Danlos syndromes (2020)
- Osteogenesis imperfecta (2017)
- Mucopolysaccharidosis (2016)
- Fibrous dysplasia of bone and McCune-Albright syndrome (2012)
- Multiple exostoses – in progress by Dr Koumakis
- Ollier-Maffucci disease – in progress by Dr Koumakis
- Achondroplasia – in progress
RESEARCH
- Osteogenesis imperfecta and anti-sclerostin NCT 03118570 – Mereo Biopharma – Completed
- Fibrodysplasia ossificans progressiva and anti-activin NCT 03188666 – Regeneron – In progress
Cohorts
- Hypophosphatasia registry – 24 patients included
EDUCATION
- UD Constitutional Bone Diseases
University of Paris
2021
– Refracture and mortality following hospitalization for severe osteoporotic fractures: The Fractos Study.
Christian Roux, Thierry Thomas, Julien Paccou, Geoffray Bizouard, Anne Crochard, Emese Toth, Magali Lemaitre, Frédérique Maurel, Laure Perrin, Florence Tubach
JBMR Plus, 2021 May 14, PMID: 34258503 PMCID: PMC8260818 DOI: 10.1002/jbm4.10507
– The Causes of Hypo- and Hyperphosphatemia in Humans.
Eugénie Koumakis, Catherine Cormier, Christian Roux, Karine Briot
Calcif Tissue Int, 2021 Jan, PMID: 32285168 DOI: 10.1007/s00223-020-00664-9
– The French multicentre elevated bone mass study: prevalence and causes.
J Paccou, R-M Javier, I Henry-Desailly, C Ternynck, A Nottez, I Legroux-Gérot, F Robin, P Fardellone, E Lespessailles, C Roux, P Guggenbuhl, S Kolta, B Cortet
Osteoporos Int, 2021 Sep, PMID: 33655400 DOI: 10.1007/s00198-021-05898-3
2020
– Homozygous Loss-of-Function Mutations in CCDC134 Are Responsible for a Severe Form of Osteogenesis Imperfecta.
Dubail J, Brunelle P, Baujat G, Huber C, Doyard M, Michot C, Chavassieux P, Khairouni A, Topouchian V, Monnot S, Koumakis E, Cormier-Daire V.
J Bone Miner Res, 2020 Aug, PMID: 32181939 DOI: 10.1002/jbmr.4011
– Real-world care for individuals aged over fifty with fractures in France: Evidence for a wide care gap-The EPIFRACT Study.
Karine Briot, Laurent Grange, Bernard Cortet, Jean-Marc Feron, Pierre Chauvin, Alain Coulomb, Françoise Alliot-Launois, Rahma Sellami, Chantal Touboul, Laure Perrin, Jean-Michel Joubert, Robert Launois
Joint Bone Spine, 2020 Oct, PMID: 32387150 DOI: 10.1016/j.jbspin.2020.04.007
– Fragility fractures in France: epidemiology, characteristics and quality of life (the EPIFRACT study).
Bernard Cortet, Pierre Chauvin, Jean-Marc Feron, Laurent Grange, Alain Coulomb, Robert Launois, Françoise Alliot-Launois, Rahma Sellami, Chantal Touboul, Benoît Vincent, Jean-Michel Joubert, Karine Briot
Arch Osteoporos, 2020 Mar 13, PMID: 32170512 DOI: 10.1007/s11657-019-0674-2
– Alendronate or Zoledronic acid do not impair wound healing after tooth extraction in postmenopausal women with osteoporosis.
Philippe Lesclous, Alexandra Cloitre, Sylvain Catros, Laurent Devoize, Béatrice Louvet, Cécile Châtel, Frantz Foissac, Christian Roux
Bone, 2020 Aug, PMID: 32404281 DOI: 10.1016/j.bone.2020.115412
– Vitamin D Supplementation in France in patients with or at risk for osteoporosis: Recent data and new practices.
Jean-Claude Souberbielle, Catherine Cormier, Etienne Cavalier, Véronique Breuil, Françoise Debiais, Patrice Fardellone, Pascal Guggenbuhl, Rose-Marie Javier, Erick Legrand, Eric Lespessailles, Julien Paccou, Thierry Thomas, Bernard Cortet, au nom du Groupe de recherche et d’information sur les ostéoporoses, (GRIO)
Joint Bone Spine, 2020 Jan, PMID: 31051244 DOI: 10.1016/j.jbspin.2019.04.004
– Hypophosphatasia in adolescents and adults: overview of diagnosis and treatment.
M L Bianchi, N J Bishop, N Guañabens, C Hofmann, F Jakob, C Roux, M C Zillikens, Rare Bone Disease Action Group of the European Calcified Tissue Society
Osteoporos Int, 2020 Aug, PMID: 32162014 DOI: 10.1007/s00198-020-05345-9
2019
– Novel function of PiT1/SLC20A1 in LPS-related inflammation and wound healing.
Koumakis, E ; Millet-Botti, J ; Benna, JE ; Leroy, C ; Boitez, V ; Codogno, P & al
Sci Rep, 2019 Feb 12, PMID: 30755642 PMCID: PMC6372663 DOI: 10.1038/s41598-018-37551-1
– Vertebral fractures cascade: potential causes and risk factors.
Che, H ; Breuil, V ; Cortet, B ; Paccou, J ; Thomas, T ; Chapuis, L & al
Osteoporos Int, 2019 Mar, PMID: 30519756 DOI: 10.1007/s00198-018-4793-1
– Measurement of Trabecular Bone Score of the Spine by Low-Dose Imaging System (EOS <sup>®</sup>): A Feasibility Study.
Kolta, S ; Etcheto, A ; Fechtenbaum, J ; Feydy, A ; Roux, C ; Briot, K
J Clin Densitom, Apr-Jun 2019, PMID: 30120025 DOI: 10.1016/j.jocd.2018.05.040
- Quand penser à une maladie osseuse rare. Congrès national de Rhumatologie – Pr Roux
- Hypercalcémies génétiques. Fédération des Rhumatologues d’Ile de France – Pr Cormier
- Grossesse et OI. Congrès National de Rhumatologie – Dr Koumakis
- Fibrodysplasie ossifiante progressive : diagnostic positif et différentiel de la FOP (03/11/2020) – Dr Koumakis
- Cas cliniques Hypophosphatasie adulte (08/12/2020) – Pr Briot, Dr Koumakis
- Cours d’éducation sur le métabolisme du calcium et du phosphate 22/11/2020 – Pr Cormier, Dr Koumakis
- Prise en charge du XLH chez l’adulte (2 fois) – Pr Briot
- IOF 2020 : Ostéogenèse imparfaite : caractéristiques des fractures durant la grossesse et en post-partum ; présentation orale – Dr Koumakis
- ECTS Congress 2020 : Ostéogenèse imparfaite : caractéristiques des fractures durant la grossesse et en post-partum ; présentation poster – Dr Koumakis
- ECTS Congress 2020 Webinar: “Transition of care in heritable forms of bone fragility » (24/10/2020) – Dr Koumakis
- Maroteaux Day Décembre 2020 : Ostéogenèse imparfaite : caractéristiques des fractures durant la grossesse et en post-partum ; présentation orale – Dr Koumakis
- Association Ostéogenèse Imparfaite (AOI)
- Un défi de taille – Association nationale des dysplasies spondylo-épi- métaphysaires
- Association Maladies Exostoses Multiples (AMEM)
- Ollier-Maffucci Europe
- Association française sur la Fibrodysplasie Ossifiante Progressive – Maladie de l’homme de pierre (FOP – France)
- Hypophosphatasie Europe
- Association du syndrome Nail Patella
- Alliance Maladies Rares
Focus on fibrodysplasia ossificans progressiva (FOP)
What is FOP?
What is fibrodysplasia ossificans progressiva? What are the suggestive signs of the disease? What are the main differential diagnoses to be ruled out? How can the diagnosis be confirmed? What are the consequences of diagnostic error?
Pr David Genevieve, clinical geneticist at the department of medical genetics, rare diseases and personalised medicine at the university hospital of Montpellier, university professor at the faculty of medicine of Montpellier and coordinator of the reference center for developmental Anomalies and malformative syndromes for the South-East Occitania region, answers questions.
> Listen to the podcast
Recognising FOP
What are the principles of radiological diagnosis of fibrodysplasia ossificans progressiva? What are the main differential diagnoses to be ruled out? What radiological follow-up should be proposed once the diagnosis has been established? What is the role of the radiologist in the management of patients in expert centers?
Dr Valérie Merzoug, radiologist attached to the radiology department B of the Cochin Hospital in Paris and to the paediatric radiology department of the Bicêtre Hospital in Kremlin-Bicêtre, answers the questions.
> Listen to the podcast
Caring for adults with FOP
What are the main clinical pictures encountered in adult patients with fibrodysplasia ossificans progressiva? What are the principles of care and its specificities for adult patients? Why refer these patients to an expert center? What are the advances to come for this rare disease?
Dr. Thomas Funck-Brentano, rheumatologist in the rheumatology department of the Lariboisière hospital in Paris, one of the constituent centers of the reference center for constitutional bone diseases, answers questions.
> Listen to the podcast
Caring for children with FOP
What are the principles of care for children with fibrodysplasia ossificans progressiva? Are there atypical forms of the disease? What is the importance of early diagnosis and how to facilitate it? What are the advantages of being taken care of by a specialized care network? Where is the research on this rare disease?
Dr Geneviève Baujat, pediatrician, clinical geneticist and FOP referent in the medical genetics department at the Necker-Enfants Malades hospital in Paris, coordinating site of the reference center for constitutional bone diseases, answers questions.
> Listen to the podcast
Living with FOP
When and how do the first symptoms of fibrodysplasia ossificans progressiva occur? What is the course of the disease? Why join a patient association? What are the objectives of the FOP France association?
Mr Fourmentin, father of a young patient with progressive fibrodysplasia ossificans and member of the FOP France association, answers questions.
> Listen to the podcast
Focus on hypophosphatasia
What is hypophosphatasia?
What is hypophosphatasia? What are the warning signs that should evoke this diagnosis, especially in children? How important is early diagnosis? What are the main differential diagnoses to be ruled out and the examinations to be performed to confirm the diagnosis?
Professor Agnès Linglart, pediatrician, university professor at the Paris-Saclay faculty of medicine, hospital practitioner, head of the pediatric endocrinology and diabetes department at Bicêtre hospital in Kremlin-Bicêtre and coordinator of the national reference center for rare diseases of calcium and phosphate metabolism from the OSCAR network, answers the questions.
> Listen to the podcast
Recognising hypophosphatasia
What are the different dental symptoms that patients with hypophosphatasia can present, what is the role of the dental surgeon? Is dental involvement systematic in hypophosphatasia? What tests should be carried out to confirm the diagnosis? What are the recommendations for the management of patients with this rare disease?
Dr Martin Biosse Duplan, dental surgeon, hospital practitioner in the oral medicine department of the Bretonneau hospital in Paris, reference center for rare diseases of calcium and phosphate metabolism in the OSCAR network, answers the questions .
> Listen to the podcast
Diagnosing hypophosphatasia in adults
How does hypophosphatasia manifest in adult patients? How to differentiate hypophosphatasia from classic osteoporosis? What to do with an undiagnosed adult patient with low alkaline phosphatase? What are the treatment modalities for adult patients with this rare disease? How important are expert centers for the care of these patients?
Professor Christian Roux, rheumatologist, university professor, head of the rheumatology department at Cochin Hospital in Paris and head of the reference center for constitutional bone diseases in adults, answers questions.
> Listen to the podcast
Caring for hypophosphatasia
What are the treatment modalities for patients with hypophosphatasia? How is care organized for this pathology in France? What are the genetic procedures to be carried out? What are the prospects for research in this rare disease?
Dr Geneviève Baujat, pediatrician, clinical geneticist, hospital practitioner in the medical genetics department of the Necker-Enfants malades hospital in Paris and member of the HPP France consortium, answers questions
> Listen to the podcast
Living with hypophosphatasia
How do the first symptoms of the disease arise? How to confirm the diagnosis? What care for young patients with hypophosphatasia? What genetic counseling for family members? What are the objectives of the hypophosphatasia Europe patient association?
Mrs. Rallu-Planchais, mother of a young patient with hypophosphatasia and president of the hypophosphatasia Europe patient association, answers questions.
> Listen to the podcast
Focus on osteogenesis imperfecta
Caring for osteogenesis imperfecta in children
What are the specificities of Osteogenesis Imperfecta in children? What are the challenges of treating this disease in children? What is the importance of care within expert centers and coordinated follow-up by the various specialists? How to improve the quality of life of children with Osteogenesis Imperfecta?
Dr. Zagorka Pejin, orthopedic surgeon involved in the care of children with Osteogenesis Imperfecta and hospital practitioner in the pediatric orthopedic surgery and traumatology department of the Necker-Enfants malades hospital in Paris, answers questions.
> Listen to the podcast
What is osteogenesis imperfecta?
What is osteogenesis imperfecta or brittle bone disease? What is the mechanism of occurrence of this rare disease? What are the main suggestive symptoms? How to diagnose patients with osteogenesis imperfecta? What are the differential diagnoses to rule out?
Pr Valérie Cormier-Daire, clinical geneticist, university professor at Paris-Descartes University and hospital practitioner, head of the clinical genetics department at the Necker-Enfants malades hospital in Paris, coordinator of the reference center for constitutional bone diseases from the OSCAR network and an Inserm research group at the Imagine Institute, answers the questions.
> Listen to the podcast
Living with osteogenesis imperfecta
How do the first symptoms of the disease arise? How is the diagnosis made? How is the management of Osteogenesis Imperfecta evolving? What is the importance of maintaining a professional activity? Why join a patient association? What are the objectives of the Osteogenesis Imperfecta Association?
Mrs Alliot, patient with Osteogenesis Imperfecta and president of the AOI – Association de l’Ostéogenesis Imparfaite patient association, answers questions.
> Listen to the podcast
Caring for osteogenesis imperfecta in adults
What are the treatment challenges for adult patients with Osteogenesis Imperfecta? What is the benefit of regular rheumatological follow-up in adulthood? What are the main symptoms to watch out for? What is the importance of coordinated follow-up between the different specialists involved in care? How is the child-adult transition a key moment? What are the current avenues of research in Osteogenesis Imperfecta?
Dr Eugénie Koumakis, rheumatologist, hospital practitioner in the rheumatology department of the Cochin hospital in Paris and member of the OSCAR network, the healthcare network dedicated to rare diseases of bone, calcium and cartilage, answers questions.
> Listen to the podcast
Contact information
Cochin hospital
> Rheumatology department
27 rue du faubourg Saint-Jacques
75014 Paris
At Cochin hospital, the reference center for constitutional bone diseases (MOC) in brief …
* data valid for 2021