Vertebral compression fractures at the onset of acute lymphoblastic leukemia in a child.
Henry Ford Hosp Med J
; 39(1): 45-8, 1991.
Article
em En
| MEDLINE
| ID: mdl-1830297
A child with acute lymphoblastic leukemia, spinal osteoporosis with vertebral compression fractures, and hypercalcemia appearing early in the course of the hematologic disease was followed for two and a half years. Bone mineral density (BMD), measured by single photon absorptiometry at the radial shaft, was within normal limits for age and sex. However, x-rays of vertebrae and vertebral BMD, measured by dual photon absorptiometry, showed marked demineralization. Despite leukemic remission, the spinal osteoporosis became worse and the patient required aggressive treatment for eight months. Treatment included 50 units of calcitonin subcutaneously every other day, 1,000 mg/day of oral calcium, and 3,000 IU/day of vitamin D. The back pain disappeared quickly, and laboratory controls showed a significant diminution of bone turnover. No new compression fractures occurred. Eighteen months later, the patient continued in remission and menarche had occurred. Dual photon absorptiometry revealed a significant "catch up" of the lumbar spine BMD. X-ray examination showed a marked remodeling of the vertebral bodies. BMD measurements in this child indicate that bone loss affected the trabecular bone compartment or occurred only at active bone marrow sites. The rapid clinical amelioration and objective biochemical, densitometric, and radiologic evidence of bone improvement warrant further clinical trials on similarly affected patients.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Osteoporose
/
Vértebras Torácicas
/
Fraturas da Coluna Vertebral
/
Leucemia-Linfoma Linfoblástico de Células Precursoras
/
Vértebras Lombares
Tipo de estudo:
Etiology_studies
Limite:
Child
/
Female
/
Humans
Idioma:
En
Revista:
Henry Ford Hosp Med J
Ano de publicação:
1991
Tipo de documento:
Article
País de afiliação:
Argentina
País de publicação:
Estados Unidos