| Approach to the patient with secondary osteoporosis. | |
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MedLine Citation:
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PMID: 20231368 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Secondary osteoporosis is characterized by low bone mass with microarchitectural alterations in bone leading to fragility fractures in the presence of an underlying disease or medication. Scenarios that are highly suspicious for secondary osteoporosis include fragility fractures in younger men or premenopausal women, very low bone mineral density (BMD) values, and fractures despite anti-osteoporotic therapy. An open-minded approach with a detailed history and physical examination combined with first-line laboratory tests are aimed at identifying clinical risk factors for fractures, osteoporosis-inducing drugs, and underlying endocrine, gastrointestinal, hematologic, or rheumatic diseases, which then need to be confirmed by specific and/or more invasive tests. BMD should be assessed with bone densitometry at the hip and spine. Lateral X-rays of the thoracic and lumbar spine should be performed to identify or exclude prevalent vertebral fractures which may be clinically silent. Management of secondary osteoporosis includes treatment of the underlying disease, modification of medications known to affect the skeleton, and specific anti-osteoporotic therapy. Calcium and vitamin D supplementation should be initiated with doses that result in normocalcemia and serum 25-hydroxyvitamin D concentrations of at least 30 ng/ml. Oral and i.v. bisphosphonates are effective and safe drugs for most forms of secondary osteoporosis. Severe osteoporosis may require the use of teriparatide. |
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Authors:
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Lorenz C Hofbauer; Christine Hamann; Peter R Ebeling |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review Date: 2010-03-15 |
Journal Detail:
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Title: European journal of endocrinology / European Federation of Endocrine Societies Volume: 162 ISSN: 1479-683X ISO Abbreviation: Eur. J. Endocrinol. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-21 Completed Date: 2010-06-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9423848 Medline TA: Eur J Endocrinol Country: England |
Other Details:
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Languages: eng Pagination: 1009-20 Citation Subset: IM |
Affiliation:
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Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III and Center of Regenerative Therapies Dresden (CRTD), Technical University Medical Center, Fetscherstrasse 74, Dresden, Germany. lorenz.hofbauer@uniklinikum-dresden.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Bone Density
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physiology Bone Density Conservation Agents / therapeutic use Endocrine System Diseases / complications* Female Gastrointestinal Diseases / complications* Humans Male Osteoporosis / diagnosis*, etiology, therapy* |
| Chemical | |
Reg. No./Substance:
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0/Bone Density Conservation Agents |
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