Article
Suggested guidelines for evaluation and treatment of glucocorticoid-induced osteoporosis for the Department of Veterans Affairs.
Endocrinology Section (111-P), McGuire Veterans Affairs Medical Center, Richmond, VA 23249, USA.
Archives of Internal Medicine (impact factor:
11.46).
12/2003;
163(21):2619-24.
DOI:10.1001/archinte.163.21.2619
pp.2619-24
Source: PubMed
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Citations (0)
- Cited In (6)
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Article: Management strategies for pulmonary sarcoidosis.
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ABSTRACT: SARCOIDOSIS IS A SYSTEMIC INFLAMMATORY CONDITION WITH AN UNEXPLAINED PREDILECTION FOR THE LUNG: over 90% of patients have radiographic or physiological abnormalities. Respiratory physicians therefore often manage patients, but any organ may be involved, with noncaseating granulomas the characteristic feature. Sarcoidosis is the commonest interstitial lung disease (ILD), differing from most other ILDs in that many patients remain asymptomatic or improve spontaneously. Careful baseline assessment of disease distribution and severity is thus central to initial management. Subsequently, the unpredictable clinical course necessitates regular monitoring. Sarcoidosis occurs worldwide, with a high prevalence in Afro-Caribbeans and those of Swedish or Danish origin. African Americans also tend to have severe disease. Oral corticosteroids have been used since the 1950s, with evidence of short to medium response; more recent studies have examined the role of inhaled steroids. Long-term benefits of steroids remain uncertain. International guidelines published in 1999 represent a consensus view endorsed by North American and European respiratory societies. Updated British guidelines on interstitial lung disease, including sarcoidosis, were published in 2008. This review describes current management strategies for pulmonary disease, including oral and inhaled steroids, commonly used alternative immunosuppressant agents, and lung transplantation. Tumor necrosis factor alpha inhibitors are briefly discussed.Therapeutics and Clinical Risk Management 07/2009; 5(3):575-84. -
Article: Osteoporosis-related simultaneous four joints fractures and dislocation after a seizure: a case report.
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ABSTRACT: A case of steroid-induced osteoporosis-related multiple fractures and dislocations are described after a seizure is reported. Patient had two years history of steroid use with no supplement or antiresorptive therapy. There was a delay in the diagnosis which affected an otherwise good outcome in such situations. It is recommended that patients on steroid should be given calcium, vitamin D, and an antiresorptive. Furthermore, a meticulous clinical examination is required in patients who are on steroids and suffer epileptic seizures to rule out skeletal injury.Journal of osteoporosis. 01/2010; 2010:808341. -
Article: Glucocorticoid-related osteoporotic fractures.
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ABSTRACT: This study was conducted to evaluate the prevalence of fractures secondary to steroid use. A total of 165 patients (100 male and 65 female) who received glucocorticoid therapy at a dose of 7.5 mg or more, or its equivalent, for more than six months were identified from July 1, 2007 to December 30, 2007. Data extracted included age, gender, dose of glucocorticoid, concomitant diseases, the use of anti-resorptive therapy, calcium and vitamin D supplementation, and the results of bone mineral density (BMD) tests, if performed. Any fragility fractures, the site involved and the treatment administered were also recorded. The data was entered and analysed using the Statistical Package for the Social Sciences. 140 patients had no fractures while 25 (15.2 percent) sustained an osteoporotic fracture. The age (p-value less than 0.5), dose of steroids (p-value less than 0.001) and duration of glucocorticoid therapy (p-value less than 0.001) were significantly higher among patients who sustained fractures. Of these, 12 were male and 13 were female. None of the patients in both groups was started on antiresorptive therapy. The dosage of glucocorticoids was higher among women than men (11.5 versus 24.5 mg/day, p-value is 0.05). The commonest sites of osteoporotic fracture were the spine (44 percent) and proximal femur (24 percent). Eight out of 11 patients had more than one vertebra involved. Fractures due to steroid-induced osteoporosis could have been prevented if appropriate measures were taken.Singapore medical journal 12/2010; 51(12):948-51. · 0.73 Impact Factor
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Keywords
3 months
augmented vitamin D
bone mineral density measurements
calcium supplementation
dual energy x-ray absorptiometry
DXA
fracture risk
fracture risk assessment
fractures
glucocorticoid therapy
Glucocorticoid-induced osteoporosis
low bone mineral density
medical centers
patients undergoing glucocorticoid therapy
proposed guidelines
start prednisone treatment
starting therapy
timely bisphosphonate treatment
urinary calcium measurements
Veterans Affairs facilities
