Idiopathic juvenile osteoporosis with a case report

Idiopatska juvenilna osteoporoza rijetka je bolest nepoznatog uzroka koja započinje u djetinjstvu, između 2. i 14. godine života, s najvećom incidencijom oko 7. godine života, 2-3 godine prije puberteta. Često se spontano povlači u razdoblju od dvije do pet godina, ili u razdoblju adolescencije. Patogeneza bolesti nije do kraja razjašnjena. Uzrokovana je primarno manjkom kalcija i fosfora, što dovodi do smanjene gustoće kosti. Multipli prijelomi dugih kostiju ruku i nogu, posebno u području rasta nove kosti (metafizama), čest su nalaz idiopatske juvenilne osteoporoze. Prijelomi nisu nastali uslijed traume ili se javljaju nakon minimalne traume, tzv. patološki prijelomi. Prijelomi kralježaka koji dovode do kolapsa kralježnice uslijed kompresivne frakture, smanjivanja visine, promjena položaja kralježnice, te teškoćama prilikom hoda također su čest nalaz. Multiple patološke frakture uzrokuju bol, dovode do ograničenja opsega pokreta, vidljivih deformacija, te zaostajanja u rastu. Dijagnoza se postavlja isključivanjem ostalih poznatih uzroka osteoporoze, uključujući bolesti vezivnog tkiva. Prikazan je slučaj jedanaestogodišnje djevojčice s idiopatskom juvenilnom osteoporozom, čija je dijagnoza postavljena isključivanjem ostalih poznatih uzroka osteoporoze. Prikazala se bolovima u lumbalnom dijelu leđa uz prisutnu kompresivnu frakturu dvaju torakalnih kralježaka. Tijekom trogodišnjeg praćenja pacijentice prikazano je poboljšanje kliničke slike i opće stanje.Idiopathic juvenile osteoporosis is a rare disease of unknown cause, which begins in childhood, between 2 and 14 years of age, with a peak of incidency around 7 years, 2-3 years before puberty. It often spontaneously disappears in a frame of 2 to 5 years, or in adolescence. Pathogenesis of a disease is not fully clarified. Primarly caused by lack of calcium and phosphorus, which leads to decreased bone mass density. Multiple fractures of long bones of arms and legs are very often findings of idiophatic juvenile osteoporosis, expecially in the growth zone (metaphisis). Fractures can not be explained by trauma, or they are present after minimal trauma, known as pathological fractures. Fractures of vertebra lead to vertebral collapse due to compressive fracture, decreasing of height, change of the position of the spine and difficulty with walking, are also very common findings. Multiple pathological fractures cause pain, limit range of motion, cause visible deformities and growth retardation. Diagnosis is made by excluding other well known causes of osteoporosis, including connective tissue diseases. This paper presents a case of an 11 year old girl with idiopathic juvenile osteoporosis diagnosed by excluding other well known causes of osteoporosis. She presented with a lumbar pain and compressive fracture of two thoracic vertebrae. During the three year follow-up an improvement of clinical signs are showed, as well as improvement of general condition