Bone Abstracts

Objectives: From late 2015 a new protocol for zoledronic acid was adopted in our centre. This led to many children changing from pamidronate (PAM) to zoledronic acid (ZA) treatment. In a minority of cases the children and/or their families felt strongly that they wanted to change back to PAM. We present the characteristics of that minority and how bone turnover markers (BTMs) and bone mineral densities (BMD) changed whilst on ZA.Method: From Nov 2016 to ...

Objectives: Weight bearing physical activity (PA) is thought to be beneficial to bone mineral accrual in childhood, but the influence of PA and sedentary time on bone microarchitecture is less well described. We examined the relationships between self-reported PA and volumetric bone mineral density (vBMD) and bone microarchitecture at the distal tibia, assessed using high resolution peripheral quantitative computed tomography (HR-pQCT).Methods: Healthy c...

Background: Osteoporosis is common in subjects with Duchenne muscular dystrophy (DMD). Studies in paediatric DMD identified a high frequency of fragility fractures but there are no studies in the adult population. Recent updated international standards of care (2018) for children and adults with DMD recommend the following for bone monitoring:- Lateral thoracolumbar spine x-rays to screen for vertebral fracture (1–2 yearly if on glucocorticoid; 2&#1...

Background: Zoledronic acid (ZA) for the treatment of osteoporosis (OP) is associated with a transient post-infusional acute phase reaction (APR) due to ZA-mediated activation of γ-δ TCR lymphocytes (γ-δTCR) and production of cytokines.Primary objective: To investigate if OP patients developing APR (APR+) after ZA infusion have lower 25-OH vitamin D (25-OHvD) levels and a higher percentage of γ-δTCR compared to patients with...

Objective: The aim of this study was to gain insight into all the current overall costs (direct medical, direct non-medical and indirect costs) of clinical fractures in osteoporotic patients aged 50 years and older in the Netherlands.Materials and methods: This prospective study was part of a larger study in which the effect of a fracture nurse on diagnosis and subsequent treatment of elderly osteoporotic patients with a recent fracture was assessed. Inc...

Objectives: Congenital adrenal hyperplasia (CAH) is a rare condition characterized by the inability of the adrenal gland to produce cortisol. The classical form is due to the deficit of 21-hydroxylase activity (21-OHD) and it accounts for 90–95% of all CAH cases. Treatment of CAH patients consists of life-long glucocorticoid therapy, which must be dosed carefully to avoid excessive or insufficient adrenal suppression. There are data showing low bone mineral density (BMD) ...

Background: Measurement and interpretation of metaphyseal shape in children is difficult. We aim to develop relevant assessment methods using commonly available spiral computed tomography (CT) scanning.Methods: We analysed 12 pairs of age and pubertal stage matched subjects from a larger group of children recruited into a non-interventional case–control study in which all had suffered trauma; half had sustained a fracture. Each subject underwent ant...

Background: Meningococcal septicaemia in childhood has a high mortality rate in the acute stage, often requiring intensive care support. Survivors are well known to have long-term sequelae in the form of neuropathy, renal scarring, loss of limbs and necrotic tissue damage. We describe here a case where a survivor of this disease developed growth plate arrest and consequent severe bowing of both tibias which now require surgical correction. Relevant literature is also reviewed....

Poor bone mineralization remains a major health problem in patients with Thal and has been linked to functional zinc deficiency despite adequate dietary intake. The global etiology of poor bone mineralization includes inadequate dietary intake of calcium and vitamin D, endocrinopathies leading to disturbed calcium homeostasis, dysregulation of the GH–IGF1 axis, and delayed puberty, all resulting in limited growth, decreased bone formation and increased bone resorption. Th...

Turner syndrome (TS) is known to be associated with increased risk of osteoporosis and fracture. Childhood treatment with GH has been considered standard of care for treatment of growth failure in TS, while the influence of GH on bone health has been poorly understood. The purpose of this study is to assess the influence of GH on bone microarchitecture on a cohort of TS subjects.TS subjects aged 16–45 were included. Bone mineral density (BMD) was as...