Spontaneous reshaping of vertebral fractures in an adolescent with osteogenesis imperfecta.

Autor:	Montero-Lopez R; Department of Pediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria., Laurer E; Department of Pediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria., Tischlinger K; Department of Pediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria., Nagy D; Institute of Medical Genetics, Med Campus IV, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria., Scala M; Competence Center for Pediatric and Gynecological Radiology, Med Campus IV, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria., Kranewitter W; Laboratory for Molecular Genetic Diagnostics, Ordensklinikum Linz, Linz, Austria., Webersinke G; Laboratory for Molecular Genetic Diagnostics, Ordensklinikum Linz, Linz, Austria., Hörtenhuber T; Department of Pediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria., Högler W; Department of Pediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria.
Jazyk:	angličtina
Zdroj:	Bone reports [Bone Rep] 2022 Jun 03; Vol. 16, pp. 101595. Date of Electronic Publication: 2022 Jun 03 (Print Publication: 2022).
DOI:	10.1016/j.bonr.2022.101595
Abstrakt:	Background: Vertebral compression fractures (VFs) are a common and severe finding in patients with osteoporosis. In children, VFs have the unique potential to reshape and regain their original configuration. Spontaneous vertebral body reshaping ( i.e. , medication-unassisted) has been reported in secondary osteoporosis. Here we describe a previously unreported spontaneous vertebral reshaping in an adolescent with osteogenesis imperfecta (OI) with multiple vertebral fractures. Case Report: A 17-year-old female was diagnosed with OI type I at 5 years of age caused by a novel frameshift variant in COL1A1 (NM_000088.4: c.540delC; p.Met181TrpfsTer84). Due to parental reservations about medication, she had never received bisphosphonate or any other bone active therapy. A lateral spine X-ray demonstrated transparent bones and no VF. However, previous spine X-rays taken at age of 6 years at an external institution showed VFs in T5-7 (Genant semiquantitative method grade I-II). The two lateral spine x-rays, taken 11 years apart, demonstrate that substantial spontaneous vertebral reshaping occurred without bone active therapy during puberty. Discussion: Vertebral reshaping is explained by the stabilization of bone mineral density (BMD) and the remaining growth capacity the children. We hypothesize that spontaneous reshaping may occur in milder forms of OI, and that puberty may be a key mediator of the phenomenon. In all children with OI and vertebral fractures, we nevertheless recommend bisphosphonate therapy since it improves bone mass, BMD, vertebral shape, physical activity and reduces fracture rates. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2022 Published by Elsevier Inc.)
Databáze:	MEDLINE
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