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Impairment of Bone Health in Pediatric Patients with Hemolytic Anemia

INTRODUCTION: Sickle cell anemia and thalassemia result in impaired bone health in both adults and youths. Children with other types of chronic hemolytic anemia may also display impaired bone health. STUDY DESIGN: To assess bone health in pediatric patients with chronic hemolytic anemia, a cross-sec...

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Autores principales: Schündeln, Michael M., Goretzki, Sarah C., Hauffa, Pia K., Wieland, Regina, Bauer, Jens, Baeder, Lena, Eggert, Angelika, Hauffa, Berthold P., Grasemann, Corinna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191967/
https://www.ncbi.nlm.nih.gov/pubmed/25299063
http://dx.doi.org/10.1371/journal.pone.0108400
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author Schündeln, Michael M.
Goretzki, Sarah C.
Hauffa, Pia K.
Wieland, Regina
Bauer, Jens
Baeder, Lena
Eggert, Angelika
Hauffa, Berthold P.
Grasemann, Corinna
author_facet Schündeln, Michael M.
Goretzki, Sarah C.
Hauffa, Pia K.
Wieland, Regina
Bauer, Jens
Baeder, Lena
Eggert, Angelika
Hauffa, Berthold P.
Grasemann, Corinna
author_sort Schündeln, Michael M.
collection PubMed
description INTRODUCTION: Sickle cell anemia and thalassemia result in impaired bone health in both adults and youths. Children with other types of chronic hemolytic anemia may also display impaired bone health. STUDY DESIGN: To assess bone health in pediatric patients with chronic hemolytic anemia, a cross-sectional study was conducted involving 45 patients with different forms of hemolytic anemia (i.e., 17 homozygous sickle cell disease and 14 hereditary spherocytosis patients). Biochemical, radiographic and anamnestic parameters of bone health were assessed. RESULTS: Vitamin D deficiency with 25 OH-vitamin D serum levels below 20 ng/ml was a common finding (80.5%) in this cohort. Bone pain was present in 31% of patients. Analysis of RANKL, osteoprotegerin (OPG) and osteocalcin levels indicated an alteration in bone modeling with significantly elevated RANKL/OPG ratios (control: 0.08+0.07; patients: 0.26+0.2, P = 0.0007). Osteocalcin levels were found to be lower in patients compared with healthy controls (68.5+39.0 ng/ml vs. 118.0+36.6 ng/ml, P = 0.0001). Multiple stepwise regression analysis revealed a significant (P<0.025) influence of LDH (partial r(2) = 0.29), diagnosis of hemolytic anemia (partial r(2) = 0.05) and age (partial r(2) = 0.03) on osteocalcin levels. Patients with homozygous sickle cell anemia were more frequently and more severely affected by impaired bone health than patients with hereditary spherocytosis. CONCLUSION: Bone health is impaired in pediatric patients with hemolytic anemia. In addition to endocrine alterations, an imbalance in the RANKL/OPG system and low levels of osteocalcin may contribute to this impairment.
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spelling pubmed-41919672014-10-14 Impairment of Bone Health in Pediatric Patients with Hemolytic Anemia Schündeln, Michael M. Goretzki, Sarah C. Hauffa, Pia K. Wieland, Regina Bauer, Jens Baeder, Lena Eggert, Angelika Hauffa, Berthold P. Grasemann, Corinna PLoS One Research Article INTRODUCTION: Sickle cell anemia and thalassemia result in impaired bone health in both adults and youths. Children with other types of chronic hemolytic anemia may also display impaired bone health. STUDY DESIGN: To assess bone health in pediatric patients with chronic hemolytic anemia, a cross-sectional study was conducted involving 45 patients with different forms of hemolytic anemia (i.e., 17 homozygous sickle cell disease and 14 hereditary spherocytosis patients). Biochemical, radiographic and anamnestic parameters of bone health were assessed. RESULTS: Vitamin D deficiency with 25 OH-vitamin D serum levels below 20 ng/ml was a common finding (80.5%) in this cohort. Bone pain was present in 31% of patients. Analysis of RANKL, osteoprotegerin (OPG) and osteocalcin levels indicated an alteration in bone modeling with significantly elevated RANKL/OPG ratios (control: 0.08+0.07; patients: 0.26+0.2, P = 0.0007). Osteocalcin levels were found to be lower in patients compared with healthy controls (68.5+39.0 ng/ml vs. 118.0+36.6 ng/ml, P = 0.0001). Multiple stepwise regression analysis revealed a significant (P<0.025) influence of LDH (partial r(2) = 0.29), diagnosis of hemolytic anemia (partial r(2) = 0.05) and age (partial r(2) = 0.03) on osteocalcin levels. Patients with homozygous sickle cell anemia were more frequently and more severely affected by impaired bone health than patients with hereditary spherocytosis. CONCLUSION: Bone health is impaired in pediatric patients with hemolytic anemia. In addition to endocrine alterations, an imbalance in the RANKL/OPG system and low levels of osteocalcin may contribute to this impairment. Public Library of Science 2014-10-09 /pmc/articles/PMC4191967/ /pubmed/25299063 http://dx.doi.org/10.1371/journal.pone.0108400 Text en © 2014 Schündeln et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Schündeln, Michael M.
Goretzki, Sarah C.
Hauffa, Pia K.
Wieland, Regina
Bauer, Jens
Baeder, Lena
Eggert, Angelika
Hauffa, Berthold P.
Grasemann, Corinna
Impairment of Bone Health in Pediatric Patients with Hemolytic Anemia
title Impairment of Bone Health in Pediatric Patients with Hemolytic Anemia
title_full Impairment of Bone Health in Pediatric Patients with Hemolytic Anemia
title_fullStr Impairment of Bone Health in Pediatric Patients with Hemolytic Anemia
title_full_unstemmed Impairment of Bone Health in Pediatric Patients with Hemolytic Anemia
title_short Impairment of Bone Health in Pediatric Patients with Hemolytic Anemia
title_sort impairment of bone health in pediatric patients with hemolytic anemia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191967/
https://www.ncbi.nlm.nih.gov/pubmed/25299063
http://dx.doi.org/10.1371/journal.pone.0108400
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