INFLUENCE OF STEROID MEDICATION ON BONE-MINERAL DENSITY IN CHILDREN WITH NEPHROTIC SYNDROME

被引:59
作者
LETTGEN, B
JEKEN, C
REINERS, C
机构
[1] Department of Paediatric, University of Essen, Essen, 45122
[2] Department of Nuclear Medicine, University of Essen, Essen, 45122
关键词
NEPHROTIC SYNDROME; STEROID THERAPY; CYCLOPHOSPHAMIDE; BONE MINERAL DENSITY; PERIPHERAL QUANTITATIVE COMPUTED TOMOGRAPHY;
D O I
10.1007/BF00869084
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Bone mineral density (BMD) was studied in 26 children with idiopathic nephrotic syndrome and in age- and sex-matched healthy controls. BMD was selectively measured in trabecular (TBD), cortical (CBD) and total bone (ED) using peripheral quantitative computed tomography. Patients showed a decrease in ED, CBD and TBD. ED and CBD were inversely correlated with the cumulative dose of steroid treatment, Of the 26 patients with high cumulative doses of steroid, 16 were also treated with cyclophosphamide. In this group ED and CBD were decreased significantly compared with the children with a low cumulative steroid dose only. Compared with controls for each subgroup, significant decreases in ED, CBD and TBD were found in the group with high cumulative doses of steroids only. The higher cumulative steroid dose and the initial steroid toxicity which made cytotoxic therapy necessary, rather than cyclophosphamide itself, may be responsible for these findings.
引用
收藏
页码:667 / 670
页数:4
相关论文
共 24 条
[11]  
Muller A., Ruegsegger E., Ruegsegger P., Peripheral QCT: a low-risk procedure to identify woman predisposed to osteoporosis, Physics in Medicine and Biology, 34, pp. 741-749, (1989)
[12]  
Faulkner K.G., Gluer C.C., Majumdar S., Lang P., Engelke K., Genant H.K., Non-invasive measurements of bone mass, structure and strength: current methods and experimental techniques, AJR, 157, pp. 1229-1237, (1991)
[13]  
Johnston C.C., Slemenda C.W., Melton L.J., Clinical use of bone densitometry, N Engl J Med, 324, pp. 1105-1109, (1991)
[14]  
Schneider P., Borner W., Mazess R.B., Barden H., The relationship of peripheral to axial bone density, Bone Miner, 4, pp. 279-287, (1988)
[15]  
Reiners, Arnold B., Brust A.S., Sonnenschein W., Precision of bone mineral measurement with the new QCT scanner Stratec SCT 900, J Nucl Med, 31, (1990)
[16]  
Liebermann E., Heuser E., Gilchrist G.S., Donnell G.N., Landing B.H., Thrombosis, nephrosis, and corticosteroid therapy, The Journal of Pediatrics, 73, pp. 320-328, (1968)
[17]  
Ehrich J.H.H., Brodehl J., Long versus standard prednisone therapy for initial treatment of idiopathic nephrotic syndrome in children, Eur J Pediatr, 152, pp. 357-361, (1993)
[18]  
Saxena K.M., Crawford J.D., The treatment of nephrosis, N Engl J Med, 272, pp. 522-526, (1965)
[19]  
Lukert B.P., Raisz L.G., Glucocorticoid-induced osteoporosis: pathogenesis and management, Ann Intern Med, 112, pp. 352-364, (1990)
[20]  
Dambacher M.A., Olah A.J., Maurer H., Gampp R., Ruegsegger P., Pathogenese, Prophylaxe und Therapie der Steroid-Osteoporose, Z Orthop, 128, pp. 234-239, (1990)