title: Osteoporosis in Pediatric Liver Transplantation.
abstract: Liver transplantation provides an important, often life-saving treatment for end-stage liver disease. Osteoporosis post-liver transplantation has been described in adults; however, this has not been described in the pediatric population to date. We present a case of a 13-year-old female patient who underwent an orthotopic liver transplant for cryptogenic liver cirrhosis. Her immunosuppressants were tacrolimus and prednisone. Four months posttransplant, she started complaining of bilateral lower limb pain and limping while walking, progressing to a point where she was almost immobile. Magnetic resonance imagining of the pelvis showed bilateral avascular necrosis involving the weight-bearing surfaces of both femoral heads, in addition to the extensive edema involving both hip joints. Bone mineral densitometry was below normal for her age at the hip and forearm. She was started on high-dose calcium and vitamin D supplement, as well as zoledronic acid with a remarkable symptomatic and functional improvement.
authors.affiliation: Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, American University of Beirut, Beirut, Lebanon wf07@aub.edu.lb.
authors.forename: Walid
authors.initials: W
authors.lastname: Faraj
authors.affiliation: Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, American University of Beirut, Beirut, Lebanon.
authors.forename: Ghina
authors.initials: G
authors.lastname: El Nounou
authors.affiliation: Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, American University of Beirut, Beirut, Lebanon.
authors.forename: Abdallah
authors.initials: A
authors.lastname: Abou Al Naaj
authors.affiliation: Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
authors.forename: Nancy
authors.initials: N
authors.lastname: Nakhoul
authors.affiliation: Department of Radiology, American University of Beirut, Beirut, Lebanon.
authors.forename: Ali
authors.initials: A
authors.lastname: Haydar
authors.affiliation: Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, American University of Beirut, Beirut, Lebanon.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Khalife
keywords: liver transplantation; osteoporosis; pediatric