[Secondary osteoporosis - relevant clinical characteristics in diagnosis and therapy].
Osteoporosis is a systemic skeletal disease causing increased fracture risk.                     According to pathogenesis, primary (70 - 80 %) and secondary osteoporosis                     (20 - 30 %) are distinguished. Secondary osteoporosis comprises all entities in                     which osteoporosis is predominantly and causally associated with certain                     diseases or conditions. The aim of this review article is to put attention to                     special features in diagnosis, prophylaxis and treatment of secondary                     osteoporosis in general and to demonstrate some forms of secondary osteoporosis                     which seem particularly important during clinical practice. The manuscript                     refers to the guidelines of the DVO 2009 for prevention, diagnosis and therapy                     of osteoporosis and selective original papers considering the special types of                     secondary osteoporosis. History, clinical examination and basic laboratory tests                     are indicative for the diagnosis of secondary osteoporosis. Its clinical                     presentation is frequently characterized by rapid development and multiple                     fractures. Therefore, early diagnosis, prophylaxis and causal treatment is                     decisive. If causal treatment is impossible, risk adaption of bone mineral                     density (BMD) for osteoporosis specific treatment is essential. Common causes                     are medications, endocrine, gastrointestinal and hematologic diseases.                     Glucocorticoid induced osteoporosis, antihormonal therapy (aromatase inhibitor                     in women with breast cancer, androgen deprivation therapy in men with prostate                     cancer) and vitamin D deficiency causing secondary hyperparathyroidism are                     presented in detail. History and basic laboratory testing are decisive to                     identify possible causes for secondary osteoporosis and to initiate early                     diagnostic procedures. The risk of severe osteoporosis can be reduced by early                     and causal treatment or by risk stratified early bone specific medication if                     causal therapy is impossible.
Fachübergreifende Gemeinschaftspraxis Endokrinologie & Nuklearmedizin, Heidelberg. gudrun.leidigbruckner@raue-praxis.de
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Leidig-Bruckner
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Raue
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Frank-Raue
D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D012307:Risk Factors
D050071:Bone Density Conservation Agents