[Severe osteoporosis with vertebral crushes in juvenile dermatomyositis. Effect of oral alendronate therapy].
Glucocorticoids are used for the treatment of inflammatory and autoimmune diseases, cancer, and in prevention of organ rejects. A frequent secondary effect of longterm treatment with corticoids is the loss of bone mass, caused by several mechanisms: decrease in the intestinal calcium absorption, increase of the renal calcium excretion at the distal renal tubule, suppressive effect on the osteoblast and also in apoptosis of osteoclasts, inhibition in local production of IGF I (Insulin-like growth factor) and IGFBPs (binding IGF I proteins necessary for bone metabolism), and decrease on osteocalcin production. Longterm treatment with corticoids is associated with osteoporosis and vertebral fractures. To improve this condition, treatment with bisphosphonates has been proposed. We present here a clinical case of a girl with dermatomyositis and severe osteoporosis with vertebral crushes, who responded well to oral bisphophonate treatment.
Tau
Cristina
C
Metabolismo Cálcico y Oseo, Endocrinología, Hospital de Pediatria J.P. Garrahan, Buenos Aires, Argentina. cristinatau1@yahoo.com.ar
Russo
Ricardo
R
D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D019386:Alendronate / Q000627:therapeutic use*; D001827:Body Height / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002136:Calcium, Dietary / Q000627:therapeutic use; D002648:Child; D003882:Dermatomyositis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins / Q000037:antagonists & inhibitors / Q000187:drug effects; D007334:Insulin-Like Growth Factor I / Q000037:antagonists & inhibitors / Q000187:drug effects; D010024:Osteoporosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014807:Vitamin D / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary; D018969:Insulin-Like Growth Factor Binding Proteins; D014807:Vitamin D; D007334:Insulin-Like Growth Factor I; D019386:Alendronate