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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 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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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 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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  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
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