Evaluation of Children with Secondary Osteoporosis: A Single-center Experience

Objective: Children with chronic diseases are at a risk of inadequate bone mineralization due to the effects of the primary disease and/or treatment. The aim of this study was to evaluate the clinical characteristics and treatment responses of patients with secondary osteoporosis.Methods: Forty-four patients with chronic diseases who had bone mineral density (BMD) Z-score of <=-2.0 on the dual-energy X-ray absorptiometry (DXA) were included.Results: Age at diagnosis of osteoporosis was 9.2 +/- 4.9 years (1.4-17.7 years). Chronic disease groups were defined as gastrointestinal (29.5%), neurological (22.7%), hematologic (18.2%), inborn errors in metabolism (11.4%), rheumatologic (9.1%), and renal (9.1%). The rate of receiving steroid treatment was 63.6%. DXA Z-score was-2.8 +/- 0.9. The fracture frequency in the long bones was 20.5%. Bisphosphonate (BP) treatment was given in 34.1% (n=15) of the patients. BP was the most commonly used in neurological diseases (50%). A significant difference was found between the initial and final DXA Z-scores in BP patients (-3.3 +/- 1.0 and-2.4 +/- 0.9; p=0.004). Conclusion: In our study, a heterogeneous group of chronic systemic diseases was evaluated, and BP treatment provided a significant improvement in BMD. Further prospective studies are still required in which clinical and radiological improvements are evaluated in large groups of patients.

Automated summary

This study evaluated the clinical characteristics and treatment responses of children with chronic diseases, finding that they are at risk of inadequate bone mineralization. Dual-energy X-ray absorptiometry (DXA) was used to assess bone mineral density, and it was found that bisphosphonate treatment significantly improved bone density.