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Title of Journal: Eur J Pediatr

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Abbravation: European Journal of Pediatrics

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Springer-Verlag

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10.1016/0031-9163(65)91005-x

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1432-1076

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Effective parenteral clodronate treatment of a chi

Authors: Ralph Melchior Bernard Zabel Jürgen Spranger Roland Schumacher
Publish Date: 2004/10/23
Volume: 164, Issue: 1, Pages: 22-27
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Abstract

We report on an 8 years and 3 months old boy with severe idiopathic juvenile osteoporosis IJO Clinical features included multiple fractures especially of the vertebrae and neurological symptoms Biological studies showed nonparathyroid hormonemediated excessive bone resorption and massive urinary calcium loss Although IJO is usually a selflimiting condition after puberty the severity of our patient’s manifestations required therapeutic intervention Clodronate dichloromethylenebisphosphonate was administered parenterally every 3 months for a period of 2 years Dramatic clinical and biochemical improvement was noted within 2 weeks All parameters of bone resorption normalised and no new fractures occurred After 6 months of treatment radiological improvement with healing of fractures and rebuilding of the vertebral plates was documented Bone mineral density increased to normal within 1 year and growth velocity was accelerated After 2 years treatment was stopped at the age of 10 years and 3 months One year later back pain and increasing pain in the knee region recurred A tibial fracture was evident and again bone mineral density was far below normal Bisphosphonate medication was reinstituted leading to rapid improvement No sideeffects were observed Conclusionparenteral clodronate therapy is effective in managing severe idiopathic juvenile osteoporosis

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