Idiopathic osteoporosis in the young

Abstract

Six patients are described with idiopathic osteoporosis which began between the ages of 4 and 16 years. In four children the disorder was mild with pain in the back, vertebral collapse, qualitatively normal iliac bone biopsies, variable calcium balance and spontaneous recovery. The two remaining patients had progressive bone disease with deformity. One with a previously normal skeleton developed changes similar to those of osteogenesis imperfecta; in the other patient, who rapidly developed structural collapse associated with severe metaphysial osteoporosis, treatment was ineffective and the histological appearances of the bone suggested osteoblastic failure. Quantitative bone histology in four patients showed no evidence of excessive active resorption; and the ratio of Type III to Type I collagen in the skin was normal, in contrast to the findings in osteogenesis imperfecta. The significance of this study in relation to previous accounts is reviewed.

Juvenile osteoporosis in a 5-year-old girl

“…This is in accordance with the findings of Jowsey and Johnson[3] but contradict several others[12] including a recent Indian study. [4] There is no consensus in the literature regarding this finding and cannot be explained by the most common hypothesis for pathogenesis which points toward an abnormality of bone formation at surfaces that are in direct contact with the marrow cavity and hence, a decrease in cancellous bone mass.…”

“…[1] However, certain cases of obscure etiology have been identified by exclusion of the above diagnoses and labeled as IJO. Dent was the first to describe its cardinal features as an onset before puberty, multiple fractures, pain in back and extremities, and radiological evidence of osteoporotic new bone and metaphyseal compression fractures.…”

“…It is characterized by prepubertal onset, and spontaneous remission with the onset of puberty. [1] We describe a case of IJO in a 5-year-old girl who was successfully treated with oral alendronate and oral calcium carbonate.…”

Osteogenesis Imperfecta and Other Defects of Bone Development as Occasional Causes of Adult Osteoporosis

“…Urine calcium excretion has been reported to be normal or increased [304]. Bone biopsies have revealed evidence of either increased bone resorption [305] or normal resorption and decreased bone formation [306]. Rauch et al examined iliac crest bone biopsies in six children with IJO, ages 9 to 12 years, compared to healthy children.…”