Abstract Ref Number = APCP852
JUVENILE OSTEOPOROSIS A CASE REPORT
Department of Child Health University of Sriwijaya Medical School Dr Mohammad Hoesin General Hospital Palembang
Background : Juvenile osteoporosis (JO) is an uncommon condition with few case reports in the literature. It classically accompanying vertebral and metaphyseal fractures during the immediate pre-puberty years but that seems to develop naturally during puberty. Current clinical treatment is complicated because of lack of understanding on the origins of JO.
Case Presentation Summary : Patient was admitted due to history of progressive kyphosis which had started one year before, accompanied by low back pain that became worse on physical activity. No fever was noted. Bone survey examination identified osteoporosis of mandible bone, hand bones, thoracolumbal vertebrae, acetabulum, bilateral femoral trochanter; also osteoporotic compression fractures of thoracal 5, 6, 8, 9, 10, 11, 12, lumbar 1 and 2. Plasma calcium status and alkaline phosphatase were within normal limits. Investigations for tuberculosis were performed to exclude tuberculous spondylitis, including Mantoux test and chest x ray, which did not indicate tuberculosis. Total vitamin D 25-OH level was 20.8 ng/ml, which was lower than normal. His Z-score of the bone mineral density was (L1–L4) : ?4.5. The treatment protocol is limited to bisphosphonate therapy, calcium, and vitamin D supplementations, had been started due to pain and fracture. Following the 6-month treatment, significant improvements were observed including freedom from pain and lack of new fracture.
Learning Points/Discussion : Juvenile osteoporosis is a sporadic disease of childhood manifesting at pre-pubertal age with pain, fractures and deformity of the axial and appendicular skeleton. It is important to differentiate the condition with other causes of osteoporosis in childhood.
Keywords: juvenile osteoporosis progressive kyphosis bone fragility low bone mass