[Vertebral osteoporosis induced by corticoids and cyclosporine ina a patient with Still disease].
We report on a 29-year-old patient who received high doses of prednisone and cyclosporine for the treatment of Still disease. She consulted about dorsolumbar pain leading to physical disability. She presented multiple vertebral fractures, decreased lumbar bone mineral density in the rank of osteoporosis, high bone turnover, and associated hypercalciuria. Cyclosporine and corticoids induced severe changes in bone and mineral metabolism. All patients in treatment with these drugs should undergo radiology, bone densitometry and biochemical determinations of mineral metabolism at the beginning of therapy. Treatment with high doses of intravenous pamidronate (225 mg in 3 months), calcitonin (200/400 IU daily), tiazide (25 mg/daily), and kinesiotherapy mitigated the pain quickly and she recovered motility. We discuss this approach of treating osteoporosis with corticoids and immunosuppressors according to the present knowledge of bone biology.
Fassi
J
J
Servicio de Endocrinología, Metabolismo y Medicina Nuclear, Hospital Italiano, Buenos Aires.
Plantalech
L
L
D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000328:Adult; D001581:Benzothiadiazines; D002116:Calcitonin / Q000008:administration & dosage; D016572:Cyclosporine / Q000009:adverse effects*; D004164:Diphosphonates / Q000008:administration & dosage; D004232:Diuretics; D005260:Female; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced* / Q000188:drug therapy; D000077268:Pamidronate; D049993:Sodium Chloride Symporter Inhibitors / Q000008:administration & dosage; D016103:Spinal Fractures / Q000139:chemically induced* / Q000188:drug therapy; D016706:Still's Disease, Adult-Onset / Q000188:drug therapy*
D000305:Adrenal Cortex Hormones; D001581:Benzothiadiazines; D004164:Diphosphonates; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors; D016572:Cyclosporine; D002116:Calcitonin; D000077268:Pamidronate