Osteoporoza wtórna u dzieci ze szczególnym uwzględnieniem endokrynopatii

Hanna Dziatkowiak, Dorota Roztoczyńska

Summary
The paper addresses secondary osteoporosis in children. The authors present the classification of childhood osteoporosis along with basic diagnostic and therapeutic methods. Hormonal disturbances are among the more common causes of secondary osteoporosis in pediatric practice, and this is why attention has been focussed on the effects of hypercortizolemia, hyperhyroidism, hyperparathyroidism, deficiency of sex hormones, insulin and growth hormone. The paper presents the most recent data from the literature and the observations made by the authors. Spine and total body densitometric studies performed for 3 years now have demonstrated a decrease of bone mineral density in children with various hormonal disturbances. The most pronounced osteoporosis has been detected in the Cushing´s syndrome, most often of iatrogenic origin, in hyperparathyroidism, in all cases of untreated hypogonadism and in children with anorexia nervosa. Hyperthyroidism, type 1 diabetes and growth hormone deficiency are also risk factors in osteoporosis, most often in patients with untreated or poorly controlled primary disease. A large group is composed of children with osteoporosis secondary to gastroalimentary tract diseases, yet this problem extends beyond the scope of the present paper.

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