Osteoporosis in children and adolescents with endocrine pathology

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November 04, 2021

Author of the article: Bogatov Viktor Borisovich

Highest qualification category. Doctor of Medical Sciences, Professor of the Department of Traumatology and Orthopedics, First Moscow Medical University. I.M. Sechenov.

Experience: 21 years

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There are diseases that are less often classified as congenital pathologies. But their appearance in children cannot be ruled out. Osteoporosis is one of these diseases. This is a bone disease.

When bones become porous and brittle, and calcium cannot be deposited in their structure, then doctors make this diagnosis. Decreased bone density is how this disease can be described.

But why does osteoporosis appear in children, how to identify it and how to treat it? Let's answer these and other questions.

Causes

As mentioned earlier, osteoporosis is rare, but it can still be congenital. If a child has relatives who have or have had osteoporosis, then he or she also has a predisposition. Certain problems with bone metabolism are common in children who have relatives who suffer from frequent traumatic fractures. So there is a hereditary factor. But there are other causes of osteoporosis in children, which depend on the age of the child.

Congenital pathology

• Complete disruption of the successful course of pregnancy.
• Premature birth (osteoporosis is often diagnosed in children who are premature).
• Hypoxia. Reduced oxygen content inside the womb is one of the main causes of osteoporosis in children.
• Hypotrophy.
• Bad habits of the mother during gestation (drinking alcohol, drugs, smoking).
• Multiple pregnancy.
• Placental pathologies.
• Chronic diseases of the mother also provoke the development of osteoporosis in children.

These are the main reasons for the appearance of the presented disease. But there are other factors that influence the development of this disease:

• insufficient break between previous births and the current pregnancy. This is due to the fact that the woman’s body simply does not have time to recover;
• disruption of the normal rhythm of life;
• unhealthy diet, insufficient time for sleep.

In babies of the first year of life

Osteoporosis of bones in children can also be diagnosed in the first year of life. This is due to the following reasons:

• vitamin D deficiency. The risk of developing rickets increases, which is a common and natural cause of childhood osteoporosis;
• certain pathologies of the gastrointestinal tract. Especially those associated with impaired calcium absorption;
• refusal of breastfeeding. If infants are fed artificial formulas (mostly low-quality and unadapted), then the risk of developing osteoporosis in children increases;
• lack of sunlight source;
• failure to comply with personal hygiene rules.

Considering all these points, it is important to provide the child with high-quality nutrition, good sleep, and frequent walks in the fresh air (mainly on sunny days). Do not forget about additional vitamins prescribed by pediatricians.

Vitamin D is especially important in the autumn-winter period. Medicines are purchased. They are available in the form of drops. 1-2 drops per day are enough to ensure the normal amount of this vitamin in the baby’s body. All this can eliminate or minimize the risk of developing childhood osteoporosis.

During adolescence

Surprisingly, osteoporosis can be diagnosed in children not only of early age, but also during adolescence. In professional circles it is also called juvenile. Various factors can influence its development:

• drinking alcohol;
• addiction to tobacco;
• use of drugs containing narcotic substances (even with short-term use and in small doses);
• poor and unhealthy nutrition;
• complete absence of dairy products in the diet. The shortage of fermented milk ingredients is especially affecting;
• sedentary lifestyle;
• lack of physical activity (if the child does not engage in physical education).

From childhood, a child should be instilled with a culture of interaction with his body. He must understand that the use of harmful substances, poor nutrition (which is often dominated by fast food and other unhealthy foods), and lack of activity can lead to quite serious consequences.

Note that osteoporosis in children during adolescence can also develop against the background of:

• poisoning with toxins;
• exposure to radiation;
• unfavorable living conditions, including heavily polluted ecology in a certain location (for example, living near factories and other industrial enterprises);
• chronic diseases of the gastrointestinal tract, liver and kidneys;
• inflammatory processes identified in the body of a teenager (for example, tuberculosis);
• physical inactivity.

But before starting treatment for osteoporosis in children, the disease must be accurately diagnosed.

Other reasons

In addition to all of the above, one more reason for the development of childhood osteoporosis should be highlighted - taking certain medications.

Such drugs include:

• hormonal agents that are made on the basis of glucocorticosteroid substances;
• anticonvulsants;
• drugs that have a chemotherapeutic effect;
• a number of antibiotics;
• medications that reduce acidity in the stomach.

It should be understood that almost all of these drugs are recommended for use solely on the recommendation of a doctor. Under no circumstances should you take or buy them yourself without a prescription from a specialist. Because not all medications are as harmless as many are accustomed to think.

Norm and deviations

First of all, the pediatrician will prescribe biochemical tests of blood and urine, which can be used to determine whether phosphorus-calcium metabolism is impaired. These partner minerals are involved in many vital metabolic processes and work hand in hand: the body cannot absorb calcium if there is not enough phosphorus, but if there is an excess of the latter, calcium is excreted from the body. That's why it's so important to maintain their balance. By comparing the data with the standard indicators for a certain age and detecting deviations, one can suspect the initial stage of osteopenia.

To clarify the diagnosis, densitometry is performed: assessment of bone tissue. Unlike adults, children are analyzed only by the so-called Z-criterion - that is, deviations from the norm in indicators depending on age and gender.

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Symptoms

Osteoporosis of bones in children can develop without visible external causes. And yet this disease can be recognized. But to a greater extent, this disease actively manifests itself in later stages. That is, when the structure of the bone tissue is already seriously destroyed. The almost complete absence of any signs is the main difficulty of osteoporosis in children, which greatly complicates treatment. Often the disease is diagnosed accidentally. For example, during an examination for a broken bone.

Certain signs indicate that your child may already have this pathology.

The main symptoms of osteoporosis in children:

• frequent fractures and cracks in bones;
• minor impact on bones, which leads to both cracks and fractures;
• change in posture;
• noticeable curvature of the spine;
• visually noticeable curvature of the shapes of the upper and lower extremities;
• slow growth rate of the child;
• fast growth rate;
• the presence of asymmetrical folds on the child’s skin and body.

These are the most common symptoms of osteoporosis in children, which help identify the presence of the disease. But this does not mean that they are talking about this pathology. All these signs can be a signal of other diseases. In any case, you should have it examined by a specialist.

But there are other symptoms of osteoporosis in children:

• frequent occurrence of caries;
• systematic headache;
• brittle bones;
• hair fragility;
• frequent complaints of fatigue;
• excessive dryness of the skin;
• tendency to seizures.

To begin treatment for osteoporosis in children, it must be diagnosed. But how?

What is osteoporosis?

Osteoporosis is a bone disease in which the bone structure has low density , increased fragility and a tendency to fracture. The weakening of the physical parameters of the bone occurs due to a lack of calcium and the inability of bone tissue cells to renew themselves.

Most often, osteoporosis is diagnosed in older people, however, the pathology can also develop in children.

In osteoporosis, the bone structure is greatly weakened

Clinical picture of osteoporosis in children

Symptoms of pathology that develops in childhood are practically invisible and blurred at the initial stage. Osteoporosis is diagnosed in children along with concomitant diseases: scoliosis, kyphosis and other pathologies that require studying the bone structure.

Childhood osteoporosis develops quite quickly, and during its development the following symptoms may be observed::

• gradual disturbance of posture and gait;
• bone pain;
• noticeable slowdown in growth;
• fractures or microfractures due to minor physical exertion;
• neurological symptoms: tingling, short-term numbness of the limbs;
• frequent headaches.

Important! Osteoporosis in children is very rare. In addition, in the early stages the disease is quite difficult to diagnose, since radiation-related diagnostics cannot be performed on children. The initial symptoms of the disease are most often associated with overwork and physical exertion in sports sections.

Degrees and classification of pathology

Pathology that develops in childhood does not have a specific classification . Osteoporosis can be described by various symptoms in accordance with morphological, etiological, pathophysiological characteristics.

As a rule, when a disease is identified, the degree of its development is noted:

• primary _ It occurs under the influence of external factors and the use of various medications. The development of pathology is not associated with parallel diseases;
• secondary _ Develops against the background of concomitant diseases.

Diseases that can provoke the development of osteoporosis in children can be either congenital or acquired.

Video: “Common Causes of Osteoporosis”

Treatment

If all the symptoms of osteoporosis in children are present and the disease is diagnosed, then appropriate therapy is prescribed. Treatment for osteoporosis in children often produces positive results. This means that modern methods can completely get rid of the disease.

• The doctor prescribes a special diet, which is dominated by foods with bone-healthy substances and vitamins. Priority is given to protein products and those containing calcium and phosphorus. One of the main elements of treatment for symptoms of osteoporosis in children is diet. Therefore, you should strictly follow your doctor's instructions.
• Special medications are prescribed, which are supplemented by a complex of vitamins. You should not choose nutritional supplements on your own. It is necessary to follow the advice of a specialist.
• Exercise therapy is prescribed.
• If you have pain and discomfort, your doctor may prescribe painkillers.
• Corsets and special underwear are being purchased to help with treatment.

Be sure to take a course of vitamin D, calcium and drugs with a high content of minerals.

More often the specialist prescribes:

• calcitonins and estrogens;
• anabolic steroids;
• somatotropic hormones.

When should you see a doctor?

Treatment for symptoms of osteoporosis in children should be prescribed by a specialist. Self-medication is unacceptable. You should contact a traumatologist-orthopedist or rheumatologist. Sometimes they resort to the help of an endocrinologist and a neurologist. JSC “Medicine” (clinic of Academician Roitberg), which is located in the central district of Moscow at 2nd Tverskoy-Yamskaya Lane 10, employs highly qualified doctors. Here you can not only carry out diagnostics, but also make an appointment with a specialist. The medical center is located near the Mayakovskaya, Belorusskaya, Novoslobodskaya, Tverskaya, and Chekhovskaya metro stations.

You should consult a doctor when the first signs of the disease appear. Especially when cases of bone fractures in children have become more frequent.

The Cunning of the Invisible Man

Loss of bone density develops slowly and gradually, it is impossible to notice it by eye. But there are five indirect signs that should alert parents:

1. The child’s cases of caries have become more frequent.

2. For some reason, hair splits, nails peel and break.

3. Pain in the legs, especially in the legs, appears from time to time.

4. The student slouches more and more, his back gets tired after sitting for a long time at homework or at the computer.

5. Your child is allergic, because of this he has dietary restrictions; he does not eat dairy products or fish.

Even one such symptom is a signal that the child needs to be examined and find out whether he really does not have enough calcium.

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Prevention of osteoporosis in children

To eliminate the possibility of the child developing the disease, it is necessary to take all necessary measures during pregnancy. You should pay attention to a balanced diet and proper sleep patterns. You cannot smoke or drink alcohol. It is necessary to follow all recommendations of the supervising physician.

During childhood, a child must have proper nutrition. Make sure you have enough vitamins and minerals. It is recommended to pay attention to additional vitamin complexes. But they must be prescribed by a doctor. Teach your child to active games and physical education.

Can we fix everything?

The process of formation of healthy bone tissue can be adjusted as the child grows. For treatment, medications containing calcium are prescribed.

There is a wide choice: for example, for the sake of prevention and in case of a slight deviation from the norm, calcium supplements with vitamin D are prescribed. If a deficiency of not only calcium, but also some microelements is detected, complex preparations are used (they also include manganese, boron, copper, zinc, magnesium ).

Since the absorption of calcium is affected by some chronic diseases, children who have them are selected with special medications, for example, for gastritis with high acidity - those that “protect” the process of its absorption from the aggression of gastric juice. The course of continued treatment is individual.

But medication alone is not enough. Treatment should be supported by a diet: cottage cheese, cheese, kefir or yoghurt, fish (salmon, sardines), meat, eggs, broccoli, bananas, and legume dishes are recommended.

And, of course, you need to make time for sports: at least for regular visits to the pool or fitness room. Precisely regular, not occasionally.