Atas Ali, Cakmak Alpay, Soran Mustafa, Soker Murat, Varma Mustafa
Department of Pediatrics, Medical School of Harran University, Sanliurfa, Turkey.
J Pediatr Hematol Oncol. 2009 Aug;31(8):588-91. doi: 10.1097/MPH.0b013e3181acd925.
Osteoporosis in children is rare and mostly secondary to such conditions as prolonged immobilization, malabsorption syndromes, corticosteroid excess, osteogenesis imperfecta, celiac disease, Turner syndrome, and malignancy. Idiopathic juvenile osteoporosis (IJO) is a very rare condition of primary bone demineralization that presents in childhood. IJO, a disease of unknown etiology, manifests typically by pain, bone deformities, and fractures. Diagnosis of IJO was made by excluding other common causes of osteoporosis in this age. Bisphosphonates, calcitriol, fluoride, and calcitonin have been administered therapeutically, but the results were equivocal. Usually the disease remits by itself. Patient that has serious osteoporosis and high thyroid stimulating hormone level was diagnosed as IJO by eliminating secondary reasons. We report this case, whose symptoms were disappeared after parenteral pamidronat treatment, and he was reexamined owing to anemia and trombositopenia, and diagnosed as B-cell acute lymphoblastic leukemia, just to emphasis the importance of close follow-ups of IJO patients.
儿童骨质疏松症较为罕见，大多继发于长期制动、吸收不良综合征、皮质类固醇过多、成骨不全、乳糜泻、特纳综合征和恶性肿瘤等情况。特发性青少年骨质疏松症（IJO）是一种在儿童期出现的原发性骨质脱矿的非常罕见的病症。IJO病因不明，典型表现为疼痛、骨骼畸形和骨折。IJO的诊断是通过排除该年龄段其他常见的骨质疏松症病因来做出的。已使用双膦酸盐、骨化三醇、氟化物和降钙素进行治疗，但结果并不明确。通常该疾病会自行缓解。通过排除继发性原因，一名患有严重骨质疏松症且促甲状腺激素水平高的患者被诊断为IJO。我们报告此病例，其症状在静脉注射帕米膦酸钠治疗后消失，后因贫血和血小板减少症接受复查，被诊断为B细胞急性淋巴细胞白血病，旨在强调对IJO患者密切随访的重要性。
