Pediatria pre prax 2/2013

Glucocorticoid-induced osteoporosis in children – pathogenesis and diagnosis

Glucocorticoids with their unique anti-inflammatory and immunosuppressive activity have found wide application in the treatment of many chronic or autoimmune diseases, not only in adults, but in the pediatric population also. Besides the benefits of long-term steroid treatment, potential negatives arise as well – concerns are particularly over their harmful effects on skeletal growth, which could have for the child‘s body far-reaching consequences. Glucocorticoids disrupt the optimal balance between the formation and resorption of bone tissue. Several clinical observational studies have confirmed a significant reduction in bone mineral density and increased incidence of fractures in children receiving prolonged treatment with prednisone. Therefore, patients on long-term corticosteroids treatment require initially and then in regular intervals screening of bone metabolism - biochemical markers of bone metabolism/turnover and densitometry, which provides data about the bone mass.

Keywords: corticosteroids, osteoporosis, DXA.