原创力文档secondary osteoporosis in patients with juvenile idiopathic arthritis次要的青少年特发性关节炎患者的骨质疏松症.pdf
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secondary osteoporosis in patients with juvenile idiopathic arthritis次要的青少年特发性关节炎患者的骨质疏松症
SAGE-Hindawi Access to Research
Journal of Osteoporosis
Volume 2011, Article ID 569417, 7 pages
doi:10.4061/2011/569417
Review Article
Secondary Osteoporosis in Patients with
Juvenile Idiopathic Arthritis
Kristyna Brabnikova Maresova1, 2
1 Institute of Rheumatology, Slupi 4, 128 50, Prague 2, Czech Republic
2 Department of Rheumatology, First Faculty of Medicine, Charles University in Prague, Kateˇrinsk´a 32,
121 08 Prague 2, Czech Republic
Correspondence should be addressed to Kristyna Brabnikova Maresova, maresova.kristyna@seznam.cz
Received 17 August 2010; Accepted 8 January 2011
Academic Editor: Pawel Szulc
Copyright © 2011 Kristyna Brabnikova Maresova. This is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Bone disease in patients with juvenile idiopathic arthritis (JIA) is associated with focal (joint erosion and juxtaarticular osteopenia)
and systemic bone loss (generalized osteopenia or reduction of bone mass density). Pathophysiology of bone loss is multifactorial
and involves particularly proinflammatory cytokines and deleterious effects of glucocorticoid therapy. Clinical studies in patients
with JIA indicate excessive activation of osteoclastogenesis and reduction of bone formation. Reduction of physical activity, muscle
atrophy caused by high disease activity, and compulsory restriction in movements are also associated with bone loss. In patients
with JIA, the disease can be complicated by growth cartilage involvement and systemic or local growth retardation. In the absence
of preventive measures, fragility fractures can occur even at an early age.
1. Introduction
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