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Osteoporosis in childhood.
Francesco Vierucci1, Giuseppe Saggese, Rolando Cimaz
1aPediatric Unit, St. Luca Hospital, Lucca bPediatric Unit, University Hospital of Pisa, Pisa cUnit of Pediatric Rheumatology, Meyer Children's Hospital, University of Florence, Florence, Italy.
Current Opinion in Rheumatology
|June 6, 2017
Summary
Early diagnosis of pediatric osteoporosis is crucial for children at risk of fractures. Bisphosphonates are a key medical treatment, but optimal use and long-term safety require further study.
Area of Science:
- Pediatrics
- Endocrinology
- Genetics
Background:
- Pediatric osteoporosis involves genetic factors and chronic diseases impacting bone mass acquisition.
- Recent discoveries include monogenic bone disorders with reduced bone mineral density and increased fragility.
- Chronic conditions and their treatments can impair bone development in children.
Purpose of the Study:
- To review recent advancements in the prevention, diagnosis, and treatment of pediatric osteoporosis.
- To highlight key findings regarding genetic influences and disease associations.
- To discuss current diagnostic and therapeutic strategies.
Main Methods:
- Review of recent scientific literature on pediatric osteoporosis.
- Analysis of findings related to genetic factors, bone disorders, and chronic disease impacts.
- Evaluation of diagnostic techniques and treatment protocols, particularly bisphosphonates.
Main Results:
- Several genes influence bone mass acquisition; new monogenic bone disorders have been identified.
- Vertebral fracture detection is key for diagnosis, independent of bone densitometry.
- Dual X-ray absorptiometry is common but requires cautious interpretation in children.
- Bisphosphonates are a primary treatment, with various protocols proposed, but optimal administration and long-term safety need more research.
Conclusions:
- Early diagnosis through careful monitoring of at-risk children is essential.
- Bisphosphonate therapy should be considered for children with persistent risk factors and poor prognosis.
- Further research is needed to optimize bisphosphonate treatment and assess long-term safety.
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