Bone mineralization in children with epidermolysis bullosa.
BACKGROUND
Various factors may have deleterious effects on bone health in patients with epidermolysis bullosa (EB).


OBJECTIVE
In a retrospective notes review, to assess bone mineralization in children with EB and to identify the relative contributions of nutrition, activity and disease severity to low bone mass.


METHODS
Thirty-nine children with EB [32 recessive dystrophic EB (RDEB), four Dowling-Meara EB simplex (DMEBS) and three junctional EB (JEB)] had lumbar spine bone mass measured using dual X-ray absorptiometry (GE Lunar Prodigy; GE Healthcare, Chalfont St Giles, U.K.). Seventy-six healthy children were also studied. Weight and height were recorded and mobility was rated.


RESULTS
Children with RDEB and JEB, but not those with DMEBS, had lower bone mineral density SD scores than controls; differences remained after adjusting for the smaller body size of the patients. Bone mass was best predicted by mobility rating.


CONCLUSIONS
Children with RDEB and JEB have low bone mass after adjusting for their smaller size, which may put them at risk for fragility fractures. Low bone mass was best predicted by the level of mobility, raising the hypothesis that improving activity or bone loading may be a potential preventive intervention in these children. However, as low bone mass may be multifactorial in these children, more detailed investigation of potential aetiological factors is required before interventions are planned.
Fewtrell
M S
MS
MRC Childhool Nutrition Research Centre, Institute of Child Health, London WC1N 1EH, UK. m.fewtrell@ich.ucl.ac.uk
Allgrove
J
J
Gordon
I
I
Brain
C
C
Atherton
D
D
Harper
J
J
Mellerio
J E
JE
Martinez
A E
AE
D015502:Absorptiometry, Photon; D000293:Adolescent; D001827:Body Height; D001835:Body Weight; D015519:Bone Density; D002113:Calcification, Physiologic; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004820:Epidermolysis Bullosa / Q000503:physiopathology*; D016108:Epidermolysis Bullosa Dystrophica / Q000503:physiopathology; D016110:Epidermolysis Bullosa Simplex / Q000503:physiopathology; D016109:Epidermolysis Bullosa, Junctional / Q000503:physiopathology; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D005082:Physical Exertion; D012189:Retrospective Studies