Bone health in adolescent females with anorexia nervosa: What is a clinician to do?
Bone health in adolescent females with anorexia nervosa: What is a clinician to do?
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DOI：
10.1002/eat.22102
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发表时间：
2013-07-01
影响因子：
5.5
通讯作者：
Misra, Madhusmita
中科院分区：
文献类型：
--
作者：
Katzman, Debra K.;Misra, Madhusmita
此病例报告的目的是提出一种治疗患有神经性厌食症(AN)和低骨密度(BMD)的青少年的药物策略。我们报告一个17.5岁的女孩，她有3年的病史，长期无法优化营养和增加体重，她已经很低的骨密度随着时间的推移而下降。用17-雌二醇贴片(100微克，每周两次)和环孕酮(每月110天，每天2.5毫克醋酸甲羟孕酮)治疗一年后，她的脊柱和髋部BMD-Z评分有所改善，并阻止了进一步的下降。这种新的治疗方法是对低骨密度风险最大的女孩的一种考虑。患有AN的青少年面临低骨密度的风险，最有效的治疗是体重和月经恢复，这可能很难达到和维持。最近的研究表明，药物治疗股骨头低骨密度的效果令人振奋。这篇文章讨论了目前与骨丢失相关的概念，以及对低骨密度风险最高的青少年的新的药理学考虑。(C)2013年，威利期刊公司。
The objective of this case report is to present a pharmacologic strategy for treatment of adolescents with anorexia nervosa (AN) and low bone mineral density (BMD). We present a 17.5-year-old girl with a 3-year history of AN and longstanding inability to optimize nutrition and gain weight, and a decrease over time in her already low BMD. A year after treatment with the 17- estradiol patch (100 mcg twice weekly) with cyclic oral progesterone (2.5 mg medroxyprogesterone acetate daily for days 110 of every month), her spine and hip BMD Z-scores improved, and a further decrease was prevented. This novel treatment is a consideration for girls with AN at greatest risk for low BMD. Adolescents with AN are at risk for low BMD, and the most effective treatment is weight and menses restoration, which can be difficult to attain and to sustain. Recent studies have shown promising results with pharmacological therapy for low BMD in AN. This article discusses current concepts related to bone loss in AN, and new pharmacologic considerations for adolescents at greatest risk for low BMD. (c) 2013 by Wiley Periodicals, Inc.