Pediatric Rheumatology Online Journal → July 2003 → Childhood Lupus→ Clinical Presentation, course and Outcomes → Abstract #94
                                                                August 2003 → Bone → Osteoporosis → Abstract #94

BONE MINERAL DENSITY MEASURED BY DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA) IN PATIENTS WITH JUVENILE ONSET SYSTEMIC LUPUS ERYTHEMATOSUS (JSLE)

K. A. Alsufyani,¹ O. Ortiz-Alvarez,¹ D. A. Cabral,¹ L. B. Tucker,¹ R. E. Petty,¹ H. Nadel,² P. N. Malleson.¹

¹Pediatric Rheumatology, University of British Columbia, Vancouver, BC, Canada; ²Pediatric Radiology, University of British Columbia, Vancouver, BC, Canada

Objective: To study the relationship between bone mineral density, and demographic and disease-related factors in JSLE.
Methods: A retrospective chart review of all patients with JSLE (1982 ACR criteria) attending British Columbia's Children's Hospital who had at least one bone density measurement by DEXA.
Potential risk factors for decreased bone density studied were: gender, ethnicity, age at onset and at time of study, disease duration, disease activity ( physician global disease activity -PGA), and duration of corticosteroid therapy prior to DEXA. Lumbar spine, hip, and total body scan were measured by the same instrument (Hologic Delphi QDR-series).
Results: 24 patients (21 female, 3 male) were studied. Mean age at disease onset: 11.8 yrs (range 6-16), mean age at study: 15.4 yrs (range 12-18), mean duration of corticosteroid therapy at study 3.1 yrs (range 0-8). Ethnicity: Chinese 9, Caucasian 4, East Indian 4, Other Asian 8.
DEXA results: the mean (± 1SD) Z scores were: lumbar spine; -0.93 (±1.3), hip;-0.92 (±1.26), total body; 0.34 (±1.3). For this study, we considered all Z scores of -1.5 to -2.5 as abnormal and Z scores of -2.5 as very abnormal .Results at the lumbar spine were normal in16/24 (66.5%), abnormal in 7/24 (29.2%), and very abnormal in 1/24 (4.2%); results at the hip were 15/24 (60%), 7/24 (28%), and 2/24 (8%) respectively and for the total body were 19/24 (79%), 4/24 (16.7%), and 1/24 (4%) respectively. 7/24 (29%) patients were either abnormal or very abnormal at 2 sites, and 3/24 (12%) patients at all 3 sites.There were no significant correlations between decreased bone density and any of the above factors (perhaps because of the relatively small sample size).
Summary: These data indicate that decreased bone density is common in patients with JSLE, and emphasize the need for improved strategies to maintain bone health in these children.