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Title of Journal: Eur J Pediatr

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Abbravation: European Journal of Pediatrics

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Effective parenteral clodronate treatment of a child with severe juvenile idiopathic osteoporosis

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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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 non-parathyroid hormone-mediated excessive bone resorption and massive urinary calcium loss. Although IJO is usually a self-limiting condition after puberty, the severity of our patient’s manifestations required therapeutic intervention. Clodronate (dichloromethylene-bisphosphonate) 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 side-effects were observed. Conclusion:parenteral clodronate therapy is effective in managing severe idiopathic juvenile osteoporosis.



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Other Papers In This Journal:

  1. Massive gastrointestinal haemorrhage in isolated intestinal Henoch-Schonlein purpura with response to intravenous immunoglobulin infusion
  2. Reversible posterior encephalopathy syndrome associated with micronodular adrenocortical disease and Cushing syndrome
  3. Auto-immune pancytopenia in a child with DiGeorge syndrome
  4. Effective parenteral clodronate treatment of a child with severe juvenile idiopathic osteoporosis
  5. Evaluation of the Omron MX3 Plus monitor for blood pressure measurement in adolescents
  6. Paroxetine during breast-feeding: infant weight gain and maternal adherence to counsel
  7. Characteristics of the menstrual cycle in 13-year-old Flemish girls and the impact of menstrual symptoms on social life
  8. Proportional assist versus assist control ventilation in premature infants
  9. Thrombus obstructing the right ventricle outflow tract in a neonate with methylenetetrahydrofolate reductase 677TT genotype
  10. Eosinophilic tubulointerstitial nephritis on treatment with isotretinoin
  11. A European Society of Paediatric and Neonatal Intensive Care (ESPNIC) survey of European critical care management of young people
  12. Clinical practice
  13. Parameters affecting length of stay in a pediatric emergency department: a retrospective observational study
  14. Clustering of (auto)immune diseases with early-onset and complicated inflammatory bowel disease
  15. Risk factors for ventilator-associated pneumonia in the neonatal intensive care unit: a meta-analysis of observational studies
  16. Onset of acquired autoimmune hypothyroidism in infancy: a presentation of delayed gross-motor development and rhabdomyolysis
  17. Unusual clinical presentation of primary hypothyroidism in a very young infant caused by autoimmune thyroiditis: case report and update of the literature
  18. A quality improvement initiative to reduce central line infection in neonates using checklists
  19. Cognition and the risk of eating disorders in Spanish adolescents: the AVENA and AFINOS studies
  20. Transient antiphospholipid antibodies associated with acute infections in children: a report of three cases and a review of the literature
  21. Eosinophilic tubulointerstitial nephritis on treatment with isotretinoin

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