BONE MINERAL DENSITY IN SYSTEMIC LUPUS ERTHEMATOSUS IN CHILDREN

系统性红斑狼疮（SLE）患儿的生存率增加 已经导致了新的疾病，如骨质减少， 相关的自发性椎体压缩风险增加 骨折和继发于与运动和其他有关的创伤的骨折 正常的童年活动。像其他患有严重疾病的孩子一样， 这些孩子特别容易发展 由于儿童时期专用于 达到峰值骨量，以及峰值骨量在 骨质疏松症的未来发展。此外，SLE患者可能 由于以下原因，患骨质疏松症的风险特别高： 他们使用糖皮质激素，避免阳光与可能的维生素D 维生素D缺乏症，肾脏疾病，对维生素D有潜在影响 羟基化，以及由于严重疾病和关节炎而导致的活性降低。 很少有研究已经执行，以评估骨矿物质密度 (BMD)在SLE儿童中， 适当的治疗是已知的。拟议的研究将描述 儿童系统性红斑狼疮中骨量减少发生率和严重程度 注意孩子的骨龄和性发育。 此外，研究将开始评价临床风险因素 与骨质疏松症有关确定风险 这些因素最终将有助于发展预防性和 治疗干预。坦纳骨密度评估 阶段和骨龄在这个项目中可能会导致骨的发展 儿童SLE的年龄特异性治疗方案。此外，委员会认为， 从这项研究中获得的信息可能适用于研究 其它自身免疫性疾病如类风湿性关节炎中的骨质减少; 以及其他接受皮质类固醇的患者， 肾病综合征和炎症性肠病。 利用两种密度测量技术，双光子X射线 吸收测定法（DXA）和单能定量计算机 断层扫描（SEQCT）将使我们能够解决目前的问题， 测量骨矿物质密度的最合适方法 孩子

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.