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It is well known, that pediatric patients with chronic rheumatic diseases suffer from bone disease. This was shown in different studies and summarised in an excellent review by Uziel et al. cited in the following chapter. As one example individuals with juvenile onset SLE are more likely to suffer from decreased bone mineral density (BMD) and hence osteoporosis (OP), compared to age mates or compared with other pediatric rheumatology patients. Factors recognized to be responsible for these effects are various cytokines and use of Glucocorticoids (GC), especially via the receptor activator of nuclear factor κB (RANK) and its ligand (RANKL) as well as the osteoprotegerin (OPG) system. Compeyrot- Lacassagne et al. found prevalence values for osteopenia and OP among patients with juvenile systemic lupus erythematodes (SLE) with rates for osteopenia of 37.5% and OP of 20.3%. They saw an association with duration and severity of disease, use of GC as well as other cytotoxic drugs and the prevalence of nephritis. In a large cohort of 1000 adult patients followed for 10 years OP rates were slightly lower at 12.1%. Similar findings have been reported for dermatomyositis. For more information about the article, kindly follow the above link.
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