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Summary of audience discussion: Porotic hyperostosis presents 

 problems of both diagnosis and etiology. Minor osteoporotic pitting 

 or outer table erosion above the temporal lines and on frontal 

 squama as well as above the occipital crest without frank thickening 

 should probably be given a descriptive label which does not bear the 

 etiological implications presumed for porotic hyperostosis. Site 

 specificity can also be a problem. While the material reviewed in 

 this presentation demonstrated involvement of both cranial porotic 

 hyperostosis and orbital cribra orbitalia in 90% of the individuals 

 studied, the range of such associations varies from to 100% in 

 different groups. It should be remembered that porotic hyperostosis 

 is an indicator of childhood, not adult, anemia, and that iron defi- 

 ciency anemia may be the consequence of blood loss or pathological 

 absorptive conditions even in individuals consuming diets of nor- 

 mally adequate iron content. Some orbital porous lesions appear to 

 be of infectious origin; in sickle-cell anemia the orbital cases occur 

 at 4-5 years of age. 



Zagreb Paleopathology Symp. 1988 



