| Autor: |
Chacham S; All India Institute of Institute of Medical Sciences, Rishikesh, India, Pasi R; Himalayan Institute of Medical Sciences, Dehradun, India, Chegondi M; University of Iowa, Carver College of Medicine, Iowa City, USA, Ahmad N; All India Institute of Institute of Medical Sciences, Rishikesh, India, Mohanty SB; All India Institute of Institute of Medical Sciences, Rishikesh, India |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of clinical research in pediatric endocrinology [J Clin Res Pediatr Endocrinol] 2020 Nov 25; Vol. 12 (4), pp. 332-339. Date of Electronic Publication: 2019 Nov 01. |
| DOI: |
10.4274/jcrpe.galenos.2019.2019.0091 |
| Abstrakt: |
Metabolic bone disease (MBD) is an important cause of morbidity in premature, very low birth weight (VLBW) and sick infants and, if left undiagnosed, may lead to structural deformities and spontaneous fractures. MBD is defined as impaired bone mineralization in a neonate with lower than expected bone mineral levels in either a fetus or a neonate of comparable gestational age and/or weight, coupled with biochemical abnormalities with or without accompanying radiological manifestations. MBD has been reported to occur in 16% to 40% of extremely low birth weight neonates and presents by 6-16 weeks after birth. Insufficient calcium and phosphorous stores during the phase of accelerated growth predispose to MBD in neonates along with the use of some medications such as caffeine or steroids, prolonged parenteral nutrition and chronic immobilization. Enhanced physical activity in preterm infants facilitates bone mineralization and weight gain. Biochemical abnormalities tend to worsen significantly, as the severity of disease progresses. These abnormalities may include hypocalcemia, hypophosphatemia, hyperphosphatasia and secondary hyperparathyroidism. In addition, urinary phosphate wasting and hypovitaminosis D can be additional complications. Conversely, biochemical abnormalities may not be accompanied by rachitic changes. Newer diagnostic modalities include non-invasive bone densitometry by quantitative ultrasound over the mid-tibial shaft. The management of MBD includes adequate calcium, phosphorous and vitamin D supplementation, along with optimum nutrition and physical activity. Similarly, preventive strategies for MBD should target nutritional enhancement in combination with enhanced physical activity. MBD usually results in preventable morbidity in preterm and VLBW neonates. Treatment consists of optimum nutritional supplementation and enhanced physical activity. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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