Severe osteoporosis and multiple vertebral collapses in a child during treatment for B-ALL.
Severe osteoporosis and multiple vertebral collapses in a child during treatment for B-ALL.
复制标题
一名儿童在 B-ALL 治疗期间出现严重骨质疏松症和多处椎体塌陷。
作者：
P. D'Angelo;V. Conter;G. Di Chiara;C. Rizzari;A. Memeo;P. Barigozzi
儿童急性淋巴细胞白血病（ALL）诊断时骨骼病变的发生率相对较高。然而，没有严重骨质疏松症合并多发性椎体塌陷继发于ALL儿童治疗的病例报道。我们报告一个9岁的B-ALL男孩的病例，在诊断时没有骨病变，在第4期积极化疗（方案B-ALL BFM 86）后，出现严重的背部疼痛和弥漫性骨质疏松症和椎体塌陷的功能障碍。他接受了降钙素、维生素D、钙、物理治疗和矫形胸衣的治疗。在接下来的2个月化疗中，骨质疏松症进展缓慢，男孩出现背侧后凸。停止抗塑治疗后，观察到临床进展改善，约6个月后凸完全消退。随访26个月，x线检查显示骨几乎完全恢复。
The incidence of bone lesions at diagnosis of childhood acute lymphoblastic leukemia (ALL) is relatively high. However, no cases of severe osteoporosis with multiple vertebral collapses secondary to treatment in children with ALL have been reported. We report the case of a 9-year-old-boy with B-ALL, with no bone lesions at the diagnosis that, following the 4th block of aggressive chemotherapy (protocol B-ALL BFM 86), presented severe back pain and functional impairment with diffuse osteoporosis and vertebral collapses. He was treated with calcitonin, vitamin D, calcium, physical therapy and orthopedic corset. Osteoporosis progressed slowly during the following 2 months of chemotherapy and the boy developed dorsal kyphosis. After discontinuing antiblastic treatment progressive clinical improvement was observed, with complete resolution of kyphosis in about 6 months. An almost complete bone recovery was seen on X-ray survey at 26-months follow-up.