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Glucocorticoids are not always deleterious for bone.

Antoon H J M van Lierop1, Neveen A T Hamdy, Socrates E Papapoulos

  • 1Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, The Netherlands.

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
|June 16, 2010
PubMed
Summary

Glucocorticoids (GCs) effectively managed van Buchem disease, a rare sclerosing bone disorder, by suppressing bone turnover. This offers a potential alternative to surgery for progressive bone disorders.

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Area of Science:

  • Endocrinology
  • Bone Biology
  • Rare Diseases

Background:

  • Van Buchem disease is a rare sclerosing bone disorder characterized by increased bone density.
  • Patients may experience complications like increased intracranial pressure due to bone overgrowth.

Observation:

  • A 23-year-old male with van Buchem disease presented with severe headaches and papilledema, indicating increased intracranial pressure.
  • Biochemical markers showed elevated bone turnover and increasing bone mineral density (BMD) before treatment.

Findings:

  • Treatment with prednisone (a glucocorticoid) for two years suppressed both bone formation and resorption.
  • Prednisone treatment halted further bone accumulation and reduced bone turnover markers.
  • Sclerostin may play a role in glucocorticoid-mediated bone resorption, but not necessarily bone formation.

Implications:

  • Glucocorticoids may offer a less invasive therapeutic option for progressive sclerosing bone disorders compared to surgery.
  • Further research is needed to elucidate the precise role of sclerostin in glucocorticoid action on bone resorption.