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Published on: January 29, 2018
Description of Bone Health Changes in a Cohort of Children With Acute Flaccid Myelitis (AFM)
Natalie Curley1, Yilin Yang2, Janet Dean3,4
1Arizona College of Osteopathic Medicine, Glendale, Arizona.
Insights
Children with acute flaccid myelitis (AFM) often experience significant bone and muscle loss, leading to fractures. Monitoring bone health and maximizing muscle mass are crucial for these patients.
Area of Science:
- Pediatric Neurology
- Bone Metabolism
- Rehabilitation Medicine
Background:
- Acute flaccid myelitis (AFM) is a rare but serious condition affecting the nervous system.
- Bone health and muscle mass changes in pediatric AFM patients are not well-characterized.
Purpose of the Study:
- To describe bone health alterations in children with AFM.
- To examine the relationship between bone health, muscle mass, muscle strength, and functional outcomes.
Main Methods:
- Retrospective analysis of 79 pediatric patients diagnosed with AFM.
- Bone density assessed using dual-energy absorptiometry (DXA).
- Muscle mass, strength, and functional performance evaluated using lean muscle mass, manual muscle testing (MMT), and Physical Abilities and Mobility Scale (PAMS).
Main Results:
- Over half of the AFM patients (52%) exhibited low bone mass (LBM).
- 18% of patients sustained fractures post-neurologic deficit onset.
- Lean muscle mass correlated with bone mass and PAMS scores, but not MMT.
- Lower limb bone density was linked to ambulatory status.
Conclusions:
- Pediatric AFM patients are at high risk for muscle and bone loss and pathological fractures.
- Close monitoring of bone health is essential for children with AFM.
- Interventions aimed at preserving bone mass and maximizing muscle mass are recommended.
Objectives:
To qualitatively describe bone health changes in children with acute flaccid myelitis (AFM) and assess relationships with muscle mass and strength and functional performance.
Methods:
Retrospective analysis of a cohort of 79 children with AFM seen consecutively in one specialized academic center between January 1, 2007, and December 31, 2019.
Results:
Of the 79 participants who were aged 4 months to 21 years old, 41 (52%) had bone density measured by dual energy absorptiometry (DXA) and 32 of them (78%) were diagnosed with low bone mass (LBM). We recorded 25 fractures that occurred after onset of neurologic deficit in 14 of the children in the cohort (18%). Lean muscle mass correlated with bone mass and functional performance as assessed by Physical Abilities and Mobility Scale (PAMS) but not with muscle strength as assessed by manual muscle testing (MMT). Bone density in the lower limbs was associated with ambulatory status.
Conclusion:
Children with AFM have a high likelihood of muscle and bone loss and frequently sustain pathologic fractures. Bone health in children with AFM should be carefully monitored, and efforts should be made to preserve bone mass and maximize muscle mass.
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