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ODP124 Sickle Cell Bone Disease and Response to Intravenous Bisphosphonates in Children

PURPOSE: To evaluate bone morbidity and the response to intravenous (IV) bisphosphonate therapy in children with Sickle Cell Disease (SCD). METHODS: We conducted a retrospective review of patient records from 2003 to 2019 at three Canadian pediatric tertiary care centers. Radiographs, magnetic reson...

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Autores principales: Todd Alexander, R, Grimbly, Chelsey, Ward, Leanne M, Escagedo, Patricia Diaz, Jaremko, Jacob L, Bruce, Aisha, Alos, Nathalie, Robinson, Marie-Eve, Konji, Victor N, Page, Marika, Simpson, Ewurabena, Pastore, Yves D, Girgis, Rose
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9624790/
http://dx.doi.org/10.1210/jendso/bvac150.365
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author Todd Alexander, R
Grimbly, Chelsey
Ward, Leanne M
Grimbly, Chelsey
Escagedo, Patricia Diaz
Jaremko, Jacob L
Bruce, Aisha
Alos, Nathalie
Robinson, Marie-Eve
Konji, Victor N
Page, Marika
Simpson, Ewurabena
Pastore, Yves D
Girgis, Rose
author_facet Todd Alexander, R
Grimbly, Chelsey
Ward, Leanne M
Grimbly, Chelsey
Escagedo, Patricia Diaz
Jaremko, Jacob L
Bruce, Aisha
Alos, Nathalie
Robinson, Marie-Eve
Konji, Victor N
Page, Marika
Simpson, Ewurabena
Pastore, Yves D
Girgis, Rose
author_sort Todd Alexander, R
collection PubMed
description PURPOSE: To evaluate bone morbidity and the response to intravenous (IV) bisphosphonate therapy in children with Sickle Cell Disease (SCD). METHODS: We conducted a retrospective review of patient records from 2003 to 2019 at three Canadian pediatric tertiary care centers. Radiographs, magnetic resonance images, and computed tomography scans were reviewed for the presence of avascular necrosis (AVN), bone infarcts, and myositis. IV bisphosphonates were offered for bone pain management. Bone mineral density was assessed by dual-energy X-ray absorptiometry (DXA). RESULTS: Forty-six children (20 girls, 43%) had bone morbidity at a mean age of 11.8 years (SD 3.9) including AVN of the femoral (17/46, 37%) and humeral (8/46, 17%) heads, H-shaped vertebral body deformities due to endplate infarcts (35/46, 76%), and non-vertebral body skeletal infarcts (15/46, 32%). Five children (5/26, 19%) had myositis overlying areas of AVN or bone infarcts visualized on magnetic resonance imaging. Twenty-three children (8/23 girls) received IV bisphosphonate therapy. They all reported significant or complete resolution of bone pain. There were no reports of sickle cell hemolytic crises, pain crises or stroke attributed to IV bisphosphonate therapy. Bone mineral apparent density Z-score increased at the lumbar spine (N=14, mean change +0.6, SD 0.4) and total body less head (N=14, mean change +0.5, SD 0.4) after IV bisphosphonate therapy (mean 1.5 years, SD 0.8). CONCLUSION: Children with SCD have the potential for extensive and early-onset bone morbidity. In this series, IV bisphosphonates were effective for bone pain analgesia and did not trigger sickle cell complications. Presentation: No date and time listed
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spelling pubmed-96247902022-11-14 ODP124 Sickle Cell Bone Disease and Response to Intravenous Bisphosphonates in Children Todd Alexander, R Grimbly, Chelsey Ward, Leanne M Grimbly, Chelsey Escagedo, Patricia Diaz Jaremko, Jacob L Bruce, Aisha Alos, Nathalie Robinson, Marie-Eve Konji, Victor N Page, Marika Simpson, Ewurabena Pastore, Yves D Girgis, Rose J Endocr Soc Bone & Mineral Metabolism PURPOSE: To evaluate bone morbidity and the response to intravenous (IV) bisphosphonate therapy in children with Sickle Cell Disease (SCD). METHODS: We conducted a retrospective review of patient records from 2003 to 2019 at three Canadian pediatric tertiary care centers. Radiographs, magnetic resonance images, and computed tomography scans were reviewed for the presence of avascular necrosis (AVN), bone infarcts, and myositis. IV bisphosphonates were offered for bone pain management. Bone mineral density was assessed by dual-energy X-ray absorptiometry (DXA). RESULTS: Forty-six children (20 girls, 43%) had bone morbidity at a mean age of 11.8 years (SD 3.9) including AVN of the femoral (17/46, 37%) and humeral (8/46, 17%) heads, H-shaped vertebral body deformities due to endplate infarcts (35/46, 76%), and non-vertebral body skeletal infarcts (15/46, 32%). Five children (5/26, 19%) had myositis overlying areas of AVN or bone infarcts visualized on magnetic resonance imaging. Twenty-three children (8/23 girls) received IV bisphosphonate therapy. They all reported significant or complete resolution of bone pain. There were no reports of sickle cell hemolytic crises, pain crises or stroke attributed to IV bisphosphonate therapy. Bone mineral apparent density Z-score increased at the lumbar spine (N=14, mean change +0.6, SD 0.4) and total body less head (N=14, mean change +0.5, SD 0.4) after IV bisphosphonate therapy (mean 1.5 years, SD 0.8). CONCLUSION: Children with SCD have the potential for extensive and early-onset bone morbidity. In this series, IV bisphosphonates were effective for bone pain analgesia and did not trigger sickle cell complications. Presentation: No date and time listed Oxford University Press 2022-11-01 /pmc/articles/PMC9624790/ http://dx.doi.org/10.1210/jendso/bvac150.365 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Bone & Mineral Metabolism
Todd Alexander, R
Grimbly, Chelsey
Ward, Leanne M
Grimbly, Chelsey
Escagedo, Patricia Diaz
Jaremko, Jacob L
Bruce, Aisha
Alos, Nathalie
Robinson, Marie-Eve
Konji, Victor N
Page, Marika
Simpson, Ewurabena
Pastore, Yves D
Girgis, Rose
ODP124 Sickle Cell Bone Disease and Response to Intravenous Bisphosphonates in Children
title ODP124 Sickle Cell Bone Disease and Response to Intravenous Bisphosphonates in Children
title_full ODP124 Sickle Cell Bone Disease and Response to Intravenous Bisphosphonates in Children
title_fullStr ODP124 Sickle Cell Bone Disease and Response to Intravenous Bisphosphonates in Children
title_full_unstemmed ODP124 Sickle Cell Bone Disease and Response to Intravenous Bisphosphonates in Children
title_short ODP124 Sickle Cell Bone Disease and Response to Intravenous Bisphosphonates in Children
title_sort odp124 sickle cell bone disease and response to intravenous bisphosphonates in children
topic Bone & Mineral Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9624790/
http://dx.doi.org/10.1210/jendso/bvac150.365
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