Rapid increase in bone mineral density in a child with osteoporosis and autoimmune hypoparathyroidism treated with PTH 1-34

C. A. Koch

doi:10.1055/s-2001-17398

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2001; 109(6): 350-354
DOI: 10.1055/s-2001-17398

Case Report

Rapid increase in bone mineral density in a child with osteoporosis and autoimmune hypoparathyroidism treated with PTH 1-34[*]

C. A. Koch

Pediatric and Reproductive Endocrinology Branch, National Institute of Child Health and Human Development; National Institutes of Health, Bethesda, Maryland, U.S.A.

Abstract

Summary:

We describe a 16-year-old girl with autoimmune polyglandular syndrome type 1 including hypoparathyroidism, who had osteoporosis that improved rapidly with parathyroid hormone replacement therapy. Patients with hypoparathyroidism usually have high bone mass. Our patient developed vertebral compression fractures at age 10, shortly after hypoparathyroidism was diagnosed. She continued to have low lumbar bone mass until age 16, when a dual energy x-ray absorptiometry (DEXA) revealed a Z score of - 2.2 SD. Several factors including decreased physical activity, total body magnesium depletion, and intermittent ketoconazole and short-term prednisone treatment, may have contributed to the development and progression of osteoporosis. Therapy with synthetic human parathyroid hormone (PTH) 1-34 rapidly normalized lumbar bone mass, as assessed by DEXA.

Key words:

Hypoparathyroidism - osteoporosis - autoimmune polyglandular syndrome - bone densitometry

Full Text

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1 * Presented as poster at the 81st Meeting of the Endocrine Society in San Diego, June 13 1999 (abstract p2-686)

Dr. Christian A. Koch

F.A.C.E., C.N.S.

National Institutes of Health

NICHD, PREB

Building 10, Rm 9D42

Bethesda, MD 20892

U.S.A.

Phone: +301 402 4620

Fax: +301 402 0180

Email: Kochc@exchange.nih.gov