Bone Abstracts

Aim: Determining level of vitamin D and other conditions in children with osteoporosis.

Methodology: Bibliography review in a worldwide basis about the issue and what we have observed.

Outcome: We studied the level of 25OHD3 in all patients with osteoporosis and osteopenia. 25OHD3 95% deficit was found in these patients when reduced bone mass occurs. There are several disorders for hypocalcemia. Intestinal malabsorption syndromes, recognizable by low concentrations of 25 hydroxyvitamin D3. Usually there is assotiation of fat malabsorption with liver failure in the aetiology of vitamin D deficiency. Paying attention to bone loss and fracture as to osteoporosis after liver transplantation. Other conditions which causes reduced bone mass are hypercalciuria, hypocalcemia, idiopatic juvenile osteoporosis, osteogenesis imperfecta, nutritional rickets, hypophosphatemic rickets, bone mineral metabolism disorders, osseous heteroplasia, fibrous dysplasia, pseudohypoparathyroidism, goitre, hypothyroidism, hyperthyroidism, hypoparathyroidism, corticosteroids, goitre and thyroidism treatment, muscular diseases, calcium, phosphorus fat and protein disorders, hypergonadotrophic and hypogonadotrophic hypogonadism, Turner’s and Down syndrome, renal diseases, cystic fibrosis, eating disorders and no physical activity. Chronic liver disease is associated with osteoporosis in children. Bone density is also decreased in the months immediately after liver transplantation. In the case of children, bone accretion is necessary for growth. Chronic liver disease and transplantation in childhood will have an adverse effect on bone metabolism and the outcome after the growth period cannot be predicted.

Discussion and conclusions: Non-pharmacologic approaches are important in osteoporosis-prevention. Include dietary modifications, exercise, determining and treating risk factors and fall prevention. Both calcium and vitamin D supplementation have been associated with reduced bone loss and decreased risk for fractures. Improvement and maintaining of bone health must be started early in life. Weight-bearing progressive physical activity. Treatment consist in acting on aetiology of decalcification, decreasing it and increasing calcium in bones, mild antiresorptive, strontium ranelate and teriparatide according as age. If female hypogonadism hormone replacement therapy, best via the transdermal route in patients with malabsorption or liver disease, is advised for the prevention of osteoporosis. As in other organ transplant recipients, bone loss occurs rapidly, so therapy is optimally started before or at the time pre-orthotopic liver transplantation.

Disclosure: The authors declared no competing interests.