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ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management.
Eur J Endocrinol 2015; 173(6):R185-97EJ

Abstract

Osteoporosis in children can be primary or secondary due to chronic disease. Awareness among paediatricians is vital to identify patients at risk of developing osteoporosis. Previous fractures and backaches are clinical predictors, and low cortical thickness and low bone density are radiological predictors of fractures. Osteogenesis Imperfecta (OI) is a rare disease and should be managed in tertiary paediatric units with the necessary multidisciplinary expertise. Modern OI management focuses on functional outcomes rather than just improving bone mineral density. While therapy for OI has improved tremendously over the last few decades, this chronic genetic condition has some unpreventable, poorly treatable and disabling complications. In children at risk of secondary osteoporosis, a high degree of suspicion needs to be exercised. In affected children, further weakening of bone should be avoided by minimising exposure to osteotoxic medication and optimising nutrition including calcium and vitamin D. Early intervention is paramount. However, it is important to identify patient groups in whom spontaneous vertebral reshaping and resolution of symptoms occur to avoid unnecessary treatment. Bisphosphonate therapy remains the pharmacological treatment of choice in both primary and secondary osteoporosis in children, despite limited evidence for its use in the latter. The duration and intensity of treatment remain a concern for long-term safety. Various new potent antiresorptive agents are being studied, but more urgently required are studies using anabolic medications that stimulate bone formation. More research is required to bridge the gaps in the evidence for management of paediatric osteoporosis.

Authors+Show Affiliations

Department of Endocrinology and DiabetesBirmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.Department of Endocrinology and DiabetesBirmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK wolfgang.hogler@bch.nhs.uk.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26041077

Citation

Saraff, Vrinda, and Wolfgang Högler. "ENDOCRINOLOGY and ADOLESCENCE: Osteoporosis in Children: Diagnosis and Management." European Journal of Endocrinology, vol. 173, no. 6, 2015, pp. R185-97.
Saraff V, Högler W. ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management. Eur J Endocrinol. 2015;173(6):R185-97.
Saraff, V., & Högler, W. (2015). ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management. European Journal of Endocrinology, 173(6), pp. R185-97. doi:10.1530/EJE-14-0865.
Saraff V, Högler W. ENDOCRINOLOGY and ADOLESCENCE: Osteoporosis in Children: Diagnosis and Management. Eur J Endocrinol. 2015;173(6):R185-97. PubMed PMID: 26041077.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management. AU - Saraff,Vrinda, AU - Högler,Wolfgang, Y1 - 2015/06/03/ PY - 2014/10/10/received PY - 2015/06/03/accepted PY - 2015/6/5/entrez PY - 2015/6/5/pubmed PY - 2016/2/3/medline SP - R185 EP - 97 JF - European journal of endocrinology JO - Eur. J. Endocrinol. VL - 173 IS - 6 N2 - Osteoporosis in children can be primary or secondary due to chronic disease. Awareness among paediatricians is vital to identify patients at risk of developing osteoporosis. Previous fractures and backaches are clinical predictors, and low cortical thickness and low bone density are radiological predictors of fractures. Osteogenesis Imperfecta (OI) is a rare disease and should be managed in tertiary paediatric units with the necessary multidisciplinary expertise. Modern OI management focuses on functional outcomes rather than just improving bone mineral density. While therapy for OI has improved tremendously over the last few decades, this chronic genetic condition has some unpreventable, poorly treatable and disabling complications. In children at risk of secondary osteoporosis, a high degree of suspicion needs to be exercised. In affected children, further weakening of bone should be avoided by minimising exposure to osteotoxic medication and optimising nutrition including calcium and vitamin D. Early intervention is paramount. However, it is important to identify patient groups in whom spontaneous vertebral reshaping and resolution of symptoms occur to avoid unnecessary treatment. Bisphosphonate therapy remains the pharmacological treatment of choice in both primary and secondary osteoporosis in children, despite limited evidence for its use in the latter. The duration and intensity of treatment remain a concern for long-term safety. Various new potent antiresorptive agents are being studied, but more urgently required are studies using anabolic medications that stimulate bone formation. More research is required to bridge the gaps in the evidence for management of paediatric osteoporosis. SN - 1479-683X UR - https://www.unboundmedicine.com/medline/citation/26041077/ENDOCRINOLOGY_AND_ADOLESCENCE:_Osteoporosis_in_children:_diagnosis_and_management_ L2 - https://eje.bioscientifica.com/doi/10.1530/EJE-14-0865 DB - PRIME DP - Unbound Medicine ER -