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Vertebral Compression Fractures in Very Early Onset Inflammatory Bowel Disease

To describe clinical characteristics and outcomes of 3 patients with very early onset inflammatory bowel disease (VEOIBD) and vertebral compression fractures. METHODS: Patients with VEOIBD receiving care at a single tertiary center were prospectively enrolled in a longitudinal data repository. Retro...

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Autores principales: Collen, Lauren V., Snapper, Scott B., Gordon, Rebecca J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins, Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004742/
https://www.ncbi.nlm.nih.gov/pubmed/36915866
http://dx.doi.org/10.1097/PG9.0000000000000283
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author Collen, Lauren V.
Snapper, Scott B.
Gordon, Rebecca J.
author_facet Collen, Lauren V.
Snapper, Scott B.
Gordon, Rebecca J.
author_sort Collen, Lauren V.
collection PubMed
description To describe clinical characteristics and outcomes of 3 patients with very early onset inflammatory bowel disease (VEOIBD) and vertebral compression fractures. METHODS: Patients with VEOIBD receiving care at a single tertiary center were prospectively enrolled in a longitudinal data repository. Retrospective chart review was performed to identify clinical characteristics and comorbidities. Those with clinically apparent vertebral compression fractures subsequently underwent an additional chart review focused on bone health. RESULTS: Three out of 216 (1.4%) patients with VEOIBD had symptomatic vertebral compression fractures. Of the 3 patients with vertebral compression fractures, all had Crohn’s disease, 2 had monogenic inflammatory bowel disease, and all reported back pain. One patient notably had a normal dual-energy X-ray absorptiometry, highlighting a potential limitation of dual-energy X-ray absorptiometry to identify increased skeletal fragility in this population. Risk factors for suboptimal bone health included chronic inflammation secondary to poorly controlled inflammatory bowel disease, substantial glucocorticoid exposure, chronic use of other medications associated with suboptimal bone health including proton pump inhibitors and granulocyte colony-stimulating factor, and solid organ transplant. Patients treated with bisphosphonates had improved clinical outcomes, with resolution of back pain and increased bone mineral density. CONCLUSIONS: Vertebral compression fracture should be considered in the differential diagnosis of patients with VEOIBD and back pain, especially in those with other risk factors for suboptimal bone health. Treatment of compression fractures with bisphosphonates resulted in resolution of back pain and improved bone density.
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spelling pubmed-100047422023-03-11 Vertebral Compression Fractures in Very Early Onset Inflammatory Bowel Disease Collen, Lauren V. Snapper, Scott B. Gordon, Rebecca J. JPGN Rep Original Article To describe clinical characteristics and outcomes of 3 patients with very early onset inflammatory bowel disease (VEOIBD) and vertebral compression fractures. METHODS: Patients with VEOIBD receiving care at a single tertiary center were prospectively enrolled in a longitudinal data repository. Retrospective chart review was performed to identify clinical characteristics and comorbidities. Those with clinically apparent vertebral compression fractures subsequently underwent an additional chart review focused on bone health. RESULTS: Three out of 216 (1.4%) patients with VEOIBD had symptomatic vertebral compression fractures. Of the 3 patients with vertebral compression fractures, all had Crohn’s disease, 2 had monogenic inflammatory bowel disease, and all reported back pain. One patient notably had a normal dual-energy X-ray absorptiometry, highlighting a potential limitation of dual-energy X-ray absorptiometry to identify increased skeletal fragility in this population. Risk factors for suboptimal bone health included chronic inflammation secondary to poorly controlled inflammatory bowel disease, substantial glucocorticoid exposure, chronic use of other medications associated with suboptimal bone health including proton pump inhibitors and granulocyte colony-stimulating factor, and solid organ transplant. Patients treated with bisphosphonates had improved clinical outcomes, with resolution of back pain and increased bone mineral density. CONCLUSIONS: Vertebral compression fracture should be considered in the differential diagnosis of patients with VEOIBD and back pain, especially in those with other risk factors for suboptimal bone health. Treatment of compression fractures with bisphosphonates resulted in resolution of back pain and improved bone density. Lippincott Williams & Wilkins, Inc. 2023-01-19 /pmc/articles/PMC10004742/ /pubmed/36915866 http://dx.doi.org/10.1097/PG9.0000000000000283 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Collen, Lauren V.
Snapper, Scott B.
Gordon, Rebecca J.
Vertebral Compression Fractures in Very Early Onset Inflammatory Bowel Disease
title Vertebral Compression Fractures in Very Early Onset Inflammatory Bowel Disease
title_full Vertebral Compression Fractures in Very Early Onset Inflammatory Bowel Disease
title_fullStr Vertebral Compression Fractures in Very Early Onset Inflammatory Bowel Disease
title_full_unstemmed Vertebral Compression Fractures in Very Early Onset Inflammatory Bowel Disease
title_short Vertebral Compression Fractures in Very Early Onset Inflammatory Bowel Disease
title_sort vertebral compression fractures in very early onset inflammatory bowel disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004742/
https://www.ncbi.nlm.nih.gov/pubmed/36915866
http://dx.doi.org/10.1097/PG9.0000000000000283
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