학술논문

Bone mineral density in patients with inherited bone marrow failure syndromes
Document Type
article
Source
Pediatric Research. 82(3)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Clinical Research
Rare Diseases
Osteoporosis
Hematology
Pediatric
Congenital
Musculoskeletal
Absorptiometry
Photon
Adolescent
Adult
Anemia
Aplastic
Bone Density
Bone Marrow Diseases
Bone Marrow Failure Disorders
Child
Female
Hemoglobinuria
Paroxysmal
Humans
Male
Middle Aged
Prevalence
Risk Factors
Young Adult
Paediatrics and Reproductive Medicine
Public Health and Health Services
Pediatrics
Paediatrics
Language
Abstract
BackgroundPatients with inherited bone marrow failure syndromes (IBMFS) may have several risk factors for low bone mineral density (BMD). We aimed to evaluate the prevalence of low BMD in IBMFS and determine the associated risk factors.MethodsPatients with IBMFS with at least one dual-energy X-ray absorptiometry (DXA) scan were evaluated. Diagnosis of each IBMFS, Fanconi anemia (FA), dyskeratosis congenita, Diamond-Blackfan anemia, and Shwachman-Diamond syndrome was confirmed by syndrome-specific tests. Data were gathered on age, height, and clinical history. DXA scans were completed at the lumbar spine, femoral neck, and forearm. BMD was adjusted for height (HAZ) in children (age ≤20 years). Low BMD was defined as a BMD Z-score and HAZ ≤-2 in adults and children, respectively, in addition to patients currently on bisphosphonate therapy.ResultsNine of thirty-five adults (26%) and eleven of forty children (27%) had low BMD. Adults with FA had significantly lower BMD Z-scores than those with other diagnoses; however, HAZ did not vary significantly in children by diagnosis. Risk factors included hypogonadism, iron overload, and glucocorticoid use.ConclusionsAdults and children with IBMFS have high prevalence of low BMD. Prompt recognition of risk factors and management are essential to optimize bone health.