Related Experiment Video
Updated: May 30, 2026
Tension-Free Weight-Bearing Model of Steroid-Induced Osteonecrosis of Femoral Head in Rats
Published on: September 27, 2024
Effect of high-dose glucocorticosteroid treatment for infantile spasms on quantitative bone parameters later in life
Tal Eidlitz-Markus1, Sarah Kivity, Hadassa Goldberg-Stern
1Department of Pediatrics E/Ambulatory Day Care Center, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. eidlitz@post.tau.ac.il
Insights
Infants treated with high-dose glucocorticosteroids for infantile spasms may experience long-term reduced bone density, particularly in the radius. This highlights the need for ongoing monitoring to prevent bone impairments.
Area of Science:
- Pediatric Endocrinology
- Bone Densitometry
- Pharmacology
Background:
- Infantile spasms often require treatment with adrenocorticotropic hormone (ACTH) and glucocorticoids.
- Prolonged high-dose glucocorticosteroid use can have potential long-term adverse effects on bone health.
- Evaluating the long-term skeletal impact of these treatments is crucial for patient management.
Purpose of the Study:
- To assess the long-term effects of infantile spasms treatment on bone density.
- To investigate the relationship between glucocorticosteroid therapy and bone ultrasound parameters in a pediatric cohort.
Main Methods:
- Quantitative bone ultrasound was performed on 30 patients (age 4.8-33 years) treated for infantile spasms.
- Bone ultrasound measurements (speed of sound Z-score) were taken on the radius and tibia.
- Patients had completed treatment with ACTH and glucocorticoids at least 2 years prior to the study.
Main Results:
- A statistically significant lower mean speed of sound Z-score was observed for the radius (-1.085 ± 1.079, P < .001).
- The tibia also showed a lower mean speed of sound Z-score (-0.22 ± 1.19), with a significant difference from the reference mean (P = .0022).
- No significant differences in bone ultrasound Z-scores were found between prepubertal and pubertal/postpubertal age groups.
Conclusions:
- A high proportion of patients treated for infantile spasms with glucocorticoids exhibit reduced radial bone speed of sound later in life.
- These findings underscore the importance of long-term follow-up to manage and prevent bone density impairments.
- Special attention may be needed for non-weight-bearing bones affected by this treatment regimen.
Abstract:
This study evaluated possible long-term effects of prolonged high-dose glucocorticosteroid administration in infancy. Thirty patients (16 male, 14 female; age 4.8-33 years) who had completed treatment with adrenocorticotropic hormone (ACTH) followed by glucocorticoids for infantile spasms at a tertiary pediatric hospital at least 2 years previously were invited to undergo quantitative bone ultrasound. The mean speed of soundZ score was -1.085 ± 1.079 for the radius and -0.22 ± 1.19 for the tibia on the nondominant side (P = .0022). The difference from the reference mean (0) was statistically significant for the radius (P < .001). There were no significant differences in radial or tibial mean speed of soundZ scores by age (prepubertal versus pubertal/postpubertal). In conclusion, a high percentage of patients treated with glucocorticoids for infantile spasms have a low radial speed of soundZ score later in life. Long-term follow-up can help to prevent and treat impairments in bone density, especially in non-weight-bearing organs.
