Pediatric Rheumatology Online Journal → August 2003 → Bone → Abstract #142

STEROID INDUCED OSTEOPOROSIS IN CHILDREN WITH RHEUMATIC DISEASES RESULTS OF A PILOT STUDY

I. Foeldvari, A. Wierk

¹Pediatric Rheumatology Clinic, At AK-Eilbek, Hamburg, Germany

Introduction: Steroid induced osteoporosis has an increasing importance in the adult rheumatology,. We proposed the question, if there is a difference in bone density / Stiffness index(SI), measured by ultrasound method, despite Vitamin-D and Calcium-supplementation, between patients with and without systemic corticosteroid treatment during the disease course with pediatric rheumatologic diseases.
Methods: Consecutive patients of the pediatric rheumatology clinic were assessed with the Lunar Achilles[sbquo> - Ultrasound Densitometer (AUD) during routine clinical follow up between June 2001 and September 2002. A part of the patients with and without corticosteroid treatment was reassessed several times to collect data on the development of SI during the study. The data of healthy controls were based on a published study where the same AUD was used (J Clinical Densitometry 2001, 4:111-120).
Results: 358 patients were assessed, 233 without receiving any systemic steroid therapy during the disease course (Group 1.) and 125 patients, who were treated with systemic steroids (Group 2.). 329 of the patients were diagnosed with JIA. The mean age of the patients was 11,61 years (range 3-23). Based on the measured values in Group 1. the values for each age group showed nearly the same as the healthy controls. The curve of the steroid treated group was running parallel but with lower values than of Group 1. In 34 patients with the corticosteroid-therapy and a follow mean follow up of 6.4 months, we could demonstrate a decrease in the mean SI-value in these patients from 73.5 to 72.5. During the same time period we assessed 29 patients of group 1 with a mean follow up = 7.7 months, where an increase of the SI value from 75 to 87 could be demonstrated.
Discussion: In this study we demonstrated, that patients without corticosteroid treatment showed nearly the same values as healthy controls for SI. At the same time we could show a decrease in SI in the corticosteroid treated group.