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Causes, mechanisms and management of paediatric osteoporosis

Outi Mäkitie1

  • 1Children's Hospital, Helsinki University Central Hospital, University of Helsinki, and Folkhälsan Research Center, P O Box 281, FIN-00029, Helsinki, Finland. outi.makitie@helsinki.fi

Nature Reviews. Rheumatology
|April 18, 2013
PubMed

Insights

Pediatric osteoporosis, including osteogenesis imperfecta and secondary causes, increases fracture risk. Prevention is key, as treatments for symptomatic pediatric osteoporosis are limited, with inadequate data on bisphosphonate use.

Area of Science:

  • Pediatric Endocrinology
  • Pediatric Rheumatology
  • Pediatric Orthopedics

Background:

  • Osteoporosis is a significant pediatric disorder impacting bone strength and fracture risk across multiple subspecialties.
  • Osteogenesis imperfecta is the most common primary childhood osteoporosis, with secondary osteoporosis arising from chronic illnesses or treatments like glucocorticoids and neuromuscular disabilities.
  • Skeletal complications can manifest as fractures in childhood or low bone mass in adulthood.

Purpose of the Study:

  • To highlight the importance of osteoporosis as a pediatric disorder.
  • To emphasize the need for understanding the skeletal effects of pediatric illnesses and their treatments.
  • To underscore the critical role of prevention in managing pediatric osteoporosis due to limited treatment options.

Main Methods:

  • Review of current understanding of pediatric osteoporosis, encompassing primary and secondary forms.
  • Analysis of common causes and skeletal sequelae of osteoporosis in children.
  • Evaluation of current management strategies, focusing on prevention and pharmacological interventions.

Main Results:

  • Osteoporosis presents a considerable challenge in pediatrics, affecting bone health and increasing fracture susceptibility.
  • Secondary osteoporosis, linked to chronic inflammation, glucocorticoid use, and neuromuscular issues, is a notable concern.
  • Effective interventions for symptomatic pediatric osteoporosis are scarce, with limited evidence on bisphosphonate efficacy and safety in this population.

Conclusions:

  • Prevention of skeletal complications is paramount in pediatric osteoporosis management.
  • Further research is essential to establish the efficacy and safety of treatments like bisphosphonates in pediatric patients, particularly those with secondary osteoporosis.
  • A comprehensive understanding of underlying conditions and therapies is crucial for timely and effective skeletal complication prevention.

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