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[Anabolic therapy of induced osteoporosis in beta-thalassaemia major: case report and literature review].
- Source :
-
Reumatismo [Reumatismo] 2010 Apr-Jun; Vol. 62 (2), pp. 119-26. - Publication Year :
- 2010
-
Abstract
- Transfusion program and chelating therapy treatment has extended the life expectancy of thalassaemic patient; osteoporosis is considered an important cause of morbidity in adult patients who display increased fracture risk. This is a case report is about a thalassaemic young female with multiple spine fractures (D11, D12 e L2) and lumbar spine DEXA - T score = -3,1 and femoral = -3,4. This was in spite of therapy with alendronate 70 mg/week from January 2006 to September 2007. The patient was subsequentently treated for 18 months with 1-34 recombinant human parathyroid hormone and colecalciferol (100.000 U/monthly). After 4 months of therapy, the patient showed a decrease in spinal pain (Roland and Morris Disability Questionnaire) and an improvement of quality of life (Qualeffo) with normalization of osteocalcin and 25-OHcolecalciferol haematic levels after 6 months. Lumbar spine and femoral DEXA - Tscore, at 18 months, rose respectively to -2,5 and -2,4. Thalassaemia-induced osteoporosis is multifactorial and its management is very difficult. Bone marrow expansion, endocrine dysfunction, iron overload and genetic factors all seem to play important roles in the development of low bone mass in these patients. Bisphosfonates have been used in the management of thalassemia induced osteoporosis but there is no data about fracture risk. Anabolic therapy for thalassemic patients requests additional study on a large scale.
- Subjects :
- Adult
Bone Density
Drug Therapy, Combination
Female
Femoral Fractures etiology
Femoral Fractures prevention & control
Humans
Lumbar Vertebrae
Osteoporosis complications
Osteoporosis diagnosis
Osteoporosis etiology
Risk Factors
Spinal Fractures etiology
Spinal Fractures prevention & control
Treatment Outcome
beta-Thalassemia complications
beta-Thalassemia diagnosis
Alendronate therapeutic use
Anabolic Agents therapeutic use
Bone Density Conservation Agents therapeutic use
Cholecalciferol therapeutic use
Osteoporosis drug therapy
Parathyroid Hormone therapeutic use
beta-Thalassemia drug therapy
Subjects
Details
- Language :
- Italian
- ISSN :
- 0048-7449
- Volume :
- 62
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Reumatismo
- Publication Type :
- Academic Journal
- Accession number :
- 20657889
- Full Text :
- https://doi.org/10.4081/reumatismo.2010.119