BONE MINERAL DENSITY IN SYSTEMIC LUPUS ERTHEMATOSUS IN CHILDREN

系统性红斑狼疮(SLE)儿童存活率的提高 导致了新的疾病，如骨质疏松症和 与之相关的自发性椎体受压风险增加 与运动和其他相关的创伤所致的继发性骨折和骨折 正常的童年活动。像其他身患重病的孩子一样， 这些儿童特别容易患上 骨质疏松症是由于儿童时期有限的时间窗所致 达到峰值骨量，以及峰值骨量在 骨量减少症的未来发展。此外，系统性红斑狼疮患者可能 患有骨质疏松症的风险特别高，原因是 他们使用糖皮质激素，避免阳光下可能的维生素D 对维生素D有潜在影响的缺乏性肾病 羟基化，严重疾病和关节炎导致活性下降。 很少有研究用来评估骨密度。 (BMD)在儿童SLE中，因此无论是发病率还是 已知适当的治疗方法。拟议的研究将描述 儿童系统性红斑狼疮骨量减少的发生率和严重程度 注意儿童的骨龄和性发育。 此外，这项研究将开始评估临床危险因素。 与这一人群中的骨量减少有关。风险识别 各种因素最终将有助于预防和预防的发展 治疗性干预。TANER背景下的骨密度评价 本项目的分期和骨龄可能会导致骨骼的发育 儿童系统性红斑狼疮的特定年龄治疗方案。此外， 从这项研究中获得的信息可能会对研究 其他自身免疫性疾病的骨量减少，如类风湿性关节炎； 以及其他接受皮质类固醇治疗的患者，如那些 肾病综合征和炎症性肠病。 双光子x射线两种密度测量技术的应用 吸光度测定法(DXA)与单能计算机定量 断层扫描(SEQCT)将使我们能够解决当前的问题 骨密度测量最合适的方法学 孩子们。

The increased survival of children with Systemic Lupus Erythematosus (SLE) into adulthood has resulted in novel morbidities such as osteopenia and the associated increased risk of spontaneous vertebral compression fractures and fractures secondary to trauma related to sports and other normal childhood activities. Like other children with severe illness, these children are particularly susceptible to the development of osteopenia due to the limited window of time during childhood dedicated to achieving peak bone mass, and the critical role of peak bone mass in the future development of osteopenia. Additionally, individuals with SLE may be at particularly high risk for the development of osteoporosis due to their use of glucocorticoids, sunshine avoidance with possible vitamin D deficiency, renal disease with potential effect on vitamin D hydroxylation, and decreased activity due to severe illness and arthritis. Very few studies have been performed to evaluate bone mineral density (BMD) in children with SLE and thus neither the incidence nor the appropriate treatment is known. The proposed study will characterize the incidence and severity of osteopenia in pediatric SLE with particular attention to the bone age and sexual development of the child. Additionally, the study will begin the evaluate the clinical risk factors associated with osteopenia in this population. Identification of risk factors will ultimately contribute to the development of preventive and therapeutic interventions. The evaluation of BMD in the context of Tanner stage and bone age in this project may result in the development of bone age-specific treatment protocols for pediatric SLE. Furthermore, information gained from this research may have application to the study of osteopenia in other autoimmune disorders, such as rheumatoid arthritis; and to other patients receiving corticosteroids such as those with nephrotic syndrome and inflammatory bowel disease. The utilization of two densitometric techniques, Dual photon x-ray absorptiometry (DXA) and Single-energy quantitative computerized tomography (SEQCT) will permit us to address the current question of the most appropriate methodology for measuring bone mineral density in children.