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Management of osteoporosis in primary biliary cirrhosis.

Abstract

Osteoporosis is not a significant problem in the majority of patients with primary biliary cirrhosis (PBC). However, substantial bone-related morbidity may occur in patients with advanced disease, in particular after liver transplantation. The cause of osteoporosis in PBC is multifactorial, and pathophysiological mechanisms specifically related to PBC have not been defined. In general, the principles of management followed in post-menopausal osteoporosis also apply in chronic liver disease. Dual energy X-ray absorptiometry is currently the method of choice for monitoring bone mineral density. Avoidance of conditions with potential negative effects on bone mass, and maintaining adequate serum vitamin D levels and calcium intake form the cornerstone in preventing osteoporosis. Bisphosphonates are the most logical choice when specific medical treatment of PBC-associated osteoporosis is indicated, as well as for preventing bone loss during glucocorticoid treatment and after liver transplantation. Recent studies suggest that active vitamin D analogues are effective alternatives in the post-transplant setting.

Authors+Show Affiliations

Department of Hepatogastroenterology, Erasmus University Hospital, Rotterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

10976019

Citation

Wolfhagen, F H., et al. "Management of Osteoporosis in Primary Biliary Cirrhosis." Bailliere's Best Practice & Research. Clinical Gastroenterology, vol. 14, no. 4, 2000, pp. 629-41.
Wolfhagen FH, van Buuren HR, Vleggaar FP, et al. Management of osteoporosis in primary biliary cirrhosis. Baillieres Best Pract Res Clin Gastroenterol. 2000;14(4):629-41.
Wolfhagen, F. H., van Buuren, H. R., Vleggaar, F. P., & Schalm, S. W. (2000). Management of osteoporosis in primary biliary cirrhosis. Bailliere's Best Practice & Research. Clinical Gastroenterology, 14(4), pp. 629-41.
Wolfhagen FH, et al. Management of Osteoporosis in Primary Biliary Cirrhosis. Baillieres Best Pract Res Clin Gastroenterol. 2000;14(4):629-41. PubMed PMID: 10976019.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of osteoporosis in primary biliary cirrhosis. AU - Wolfhagen,F H, AU - van Buuren,H R, AU - Vleggaar,F P, AU - Schalm,S W, PY - 2000/9/8/pubmed PY - 2000/10/21/medline PY - 2000/9/8/entrez SP - 629 EP - 41 JF - Bailliere's best practice & research. Clinical gastroenterology JO - Baillieres Best Pract Res Clin Gastroenterol VL - 14 IS - 4 N2 - Osteoporosis is not a significant problem in the majority of patients with primary biliary cirrhosis (PBC). However, substantial bone-related morbidity may occur in patients with advanced disease, in particular after liver transplantation. The cause of osteoporosis in PBC is multifactorial, and pathophysiological mechanisms specifically related to PBC have not been defined. In general, the principles of management followed in post-menopausal osteoporosis also apply in chronic liver disease. Dual energy X-ray absorptiometry is currently the method of choice for monitoring bone mineral density. Avoidance of conditions with potential negative effects on bone mass, and maintaining adequate serum vitamin D levels and calcium intake form the cornerstone in preventing osteoporosis. Bisphosphonates are the most logical choice when specific medical treatment of PBC-associated osteoporosis is indicated, as well as for preventing bone loss during glucocorticoid treatment and after liver transplantation. Recent studies suggest that active vitamin D analogues are effective alternatives in the post-transplant setting. UR - https://www.unboundmedicine.com/medline/citation/10976019/Management_of_osteoporosis_in_primary_biliary_cirrhosis_ L2 - http://www.diseaseinfosearch.org/result/5940 DB - PRIME DP - Unbound Medicine ER -