Brown J J, Ramalingam L, Zacharin M R
Monash Medical Centre, Clayton 3168, Victoria, Australia.
Clin Endocrinol (Oxf). 2008 Jun;68(6):863-7. doi: 10.1111/j.1365-2265.2008.03189.x. Epub 2008 Jan 21.
Bisphosphonate use in adult patients has been linked to osteonecrosis of the jaw (ONJ). This complication has not been systematically assessed in a paediatric population receiving bisphosphonates.
To assess our cohort of paediatric patients treated with intravenous bisphosphonate for occurrence of ONJ.
Observational study at a tertiary children's hospital.
A total of 42 paediatric patients with osteoporosis who received bisphosphonate infusions for a mean of 6.5 years (SD 2.7 years) were assessed clinically and radiographically for possible ONJ. Among 42, 37 patients had received disodium pamidronate 1 mg/kg/dose at a mean cumulative dose of 19.8 mg/kg and zoledronic acid (ZA) 0.05 mg/kg/dose at a mean cumulative dose of 0.49 mg/kg; four had received ZA and one received pamidronate alone. Invasive dental treatment during bisphosphonate treatment, a known risk factor for osteonecrosis, was specifically assessed.
In all patients assessed, including 11 who had invasive dental treatment, there were no cases of osteonecrosis.
ONJ has so far not been demonstrated in this patient group.
在成年患者中使用双膦酸盐与颌骨坏死（ONJ）有关。在接受双膦酸盐治疗的儿科人群中，尚未对这种并发症进行系统评估。
评估我们这组接受静脉注射双膦酸盐治疗的儿科患者中ONJ的发生情况。
在一家三级儿童医院进行的观察性研究。
共有42例患有骨质疏松症的儿科患者接受了双膦酸盐输注，平均时间为6.5年（标准差2.7年），对其进行了临床和影像学评估，以确定是否可能发生ONJ。在这42例患者中，37例接受了帕米膦酸钠二钠，剂量为1mg/kg/剂量，平均累积剂量为19.8mg/kg，唑来膦酸（ZA）剂量为0.05mg/kg/剂量，平均累积剂量为0.49mg/kg；4例接受了ZA，1例仅接受了帕米膦酸钠。对双膦酸盐治疗期间的侵入性牙科治疗这一已知的骨坏死危险因素进行了专门评估。
在所有接受评估的患者中，包括11例接受侵入性牙科治疗的患者，均未出现骨坏死病例。
到目前为止，该患者群体中尚未证实存在ONJ。
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