Secondary osteoporosis in paediatric subjects

Osteoporosis in children can be secondary to chronic diseases or medical treatments. To identify patients at risk
of osteoporosis is crucial to avoid fragility fractures, which compromise permanently the quality of life. History
of fractures or chronic back pain, in absence of causal factors, are clinical elements of suspicions. Prolonged
immobilization and movement impairment, due to trauma or to genetic diseases, are the most common causes
of secondary osteoporosis in children. Bone structure is weakened by the loss of the resistance-induced
osteosynthesis. Tumors affecting hematopoietic cells cause osteoporosis in consequence of the release of osteoclast-
stimulating factors by cancer cells. The destruction of bone tissue secondary to tumor growth partecipate
to bone damage too. Malnutrition and hormonal dysfunctions, mainly in female children, are responsible of
bone fragility for estrogenic impairment. Corticosteroids and anti-epileptic drugs affect bone metabolism, interfering
with osteoclast/osteoblast balance and with bone mineralization processes involving calcium and vitamin
D.

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