DEVELOPMENT OF OSTEOPOROSIS IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS
Journal Title: Праці Наукового товариства ім. Шевченка - Year 2015, Vol 43, Issue 2
Abstract
A literature review o f various causes of osteoporosis in children and young adults with a history o f Juvenile idiopathic arthritis (JIA) was conducted in the article. In Ukraine, the number of cases o f JIA is 24/100000 annually, with the highest incidence documented in Chernihiv region (48/100000), and lowest — in Kherson and Ivano-Frankivsk regions (29 and 28/100000 respectively). Although it is traditionally believed that osteoporosis is inherent mainly to older people, young people with JIA often exhibit significant loss of bone mineral density (BMD). This is caused by several factors such as 1) the presence of chronic inflammation; 2) therapy with glucocorticoids (GC); 3) hypodynamia due to pain and marked hypotrophy o f muscles. The role o f various pro-inflammatory cytokines, RANK/ RANKL, matrix metalloproteinases (MMPs) in BMD was analysed. Particular attention was paid to the connection o f height o f patients with JIA and osteoporosis and the role of growth hormone and insulin-like growth factor I. An important difference between JIA and rheumatoid arthritis in adults consists in growth delay in children with JIA: deceleration o f growth, low height in adulthood, and local deceleration o f growth in the areas of the inflamed joints. Significantly lower height was detected in 11% o f children with JIA and in 41% o f children with a systemic form of the disease.The influence o f GC, metotrexate, biological treatment with underlying ostoporosis was discussed. So, early diagnosis and effective treatment of JIA in children and adolescents may improve mineral bone density. However, patients suffering from JIA in childhood and adolescence can lose bone mass and, therefore, belong to the group with higher risk o f bone fractures due to osteoporosis in older age.
Authors and Affiliations
Marta DZHUS
Keywords
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