Evaluation of The Children with Secondary Osteoporosis: A Single-Center Experience

Introduction: Osteoporosis is a skeletal disease characterized by low bone mass, which increases the risk of fractures and can arise from primary or secondary causes. The aim of this study is to evaluate the frequency and causes of secondary osteoporosis diagnosis in patients presenting to our clinic, as well as to assess the clinical characteristics and treatment responses of these patients. Materials and Methods: Seventy patients with secondary osteoporosis, who were followed and treated for at least two years due to chronic disease, were included in the study. The clinical characteristics, comorbidities, medications used, laboratory tests, Dual X-ray Absorptiometry (DXA) scans, magnetic resonance imaging results, and treatment protocols of the patients were evaluated. Results: The mean age of the patients was 10.37±3.81 years. The mean age at diagnosis of the primary disease (chronic illness) was 4.47±3.54 years. The mean duration for the development of osteoporosis was 5.76±4.31 years. Among the cases, 21 (30%) had oncological, 15 (21.5%) had rheumatological, 11 (15.7%) had nephrological, 11 (15.7%) had hematological, 4 (5.7%) had neurological diseases, and 8 (11.4%) had other diseases. Of the patients, 35 (50%) had a history of steroid use, 16 (22.9%) used both steroids and methotrexate (MTX), 10 (14.3%) used MTX, and 9 (12.9%) used antiepileptic drugs. The mean vertebral DXA Z-score before treatment was -3.06±1.05, while the DXA Z-scores at the 1st and 2nd years of treatment were -2.51±1.09 and -2.16±1.15, respectively. A significant difference was found between the pre-treatment and 1st and 2nd year DXA Z-scores (p<0.001). Conclusion: In our study, patients with secondary osteoporosis caused by various chronic diseases and their treatments were evaluated. With treatment, significant positive changes in bone mineral density and clinical findings were observed. There is a need for the development of guidelines for the diagnosis, treatment, and follow-up of secondary osteoporosis patients and for the creation of larger databases through prospective studies to guide clinical practices.