Bone mineral density and vitamin D status in children with chronic neurological syndromes - clinical observations

Diagnosis of secondary osteoporosis – long-term observations in children with myelomeningocele and cerebral palsy

“…Vitamin D level were also measured in the presented group of children and adolescents, with low values found in 60%. Other authors made similar observations and therefore, similarly to our previous report, they recommend the assessment of vitamin D levels in these patients (6,(16)(17)(18) .…”

“…According to the literature and our own observations, it can be concluded that the most important factor leading to low BMD is low or absent spontaneous motor activity due to the underlying disease (CP, history of MMC surgery), which increases the risk of fractures (2,3,6,18,19,23) . It is worth noting that in the studied population, low BMD was not always associated with bone fractures, and vertebral fractures occurred in only 3 patients.…”

“…Supplementation of calcium and vitamin D in prophylactic doses under serum concentrations monitoring is recommended in disabled patients with an increased risk of osteoporosis. In the case of fractures, it is recommended to extend the diagnosis to include laboratory, radiological and densitometric tests, and even treatment with bisphosphonates (4,6,7,12) . The diagnosis of secondary osteoporosis in children significantly affects their quality of life, therefore it is necessary to use calcium, vitamin D and bisphosphonate (5,24,25) .…”

“…In some patients, the examination was performed only in the AP SPINE option, because the measurement site was adjusted to the possibility of performing and interpreting the result, depending on the deformities of the skeletal system and the patient's clinical condition during examination. The current literature emphasizes that bone densitometry is part of a comprehensive assessment of skeletal system in children and adolescents with an increased risk of bone fractures (1,6,11,12) . The increased risk of bone fracture concerns mainly patients receiving long-term glucocorticosteroids and anticonvulsants (1,5) .…”

“…In addition, chronic diseases during child's development that require long-term treatment, hospital stays and limitations of children's own activity may affect the skeletal system and therefore it is recommended to perform bone densitometry in this group (1,5) . A diagnosis of low bone mass density (BMD) may indicate an increased risk of clinically significant bone fractures and the need for use vitamin D and calcium supplements, and even bisphosphonates (6,7) .…”