Document Detail

Osteoporosis: an ignored complication of CVID.
MedLine Citation:
PMID:  21645119     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Multiple factors in common variable immunodeficiency (CVID) might interfere with optimal growth and maturation and potentially compromise bone health.
METHODS: We aimed to evaluate bone mineral density (BMD) of patients with CVID using dual energy X-ray absorptiometry (DEXA) and investigate risk factors associated with decreased bone density.
RESULTS: Twenty-two patients were included (M: 16, F: 6) with a mean age of 15.6 ± 9.0 yr. DEXA revealed osteopenia in 6/22 (27.3%) and osteoporosis in 9/22 (40.9%) at lumbar spine and osteopenia in 7/19 (37%) and osteoporosis in 3/19 (16%) at femoral neck sites. The age of subjects with osteoporosis was significantly higher than those without (21.6 ± 8.0 vs. 9.0 ± 5.7 yr; p < 0.0001). BMD z-scores were significantly lower in patients with bronchiectasis compared with those without (p = 0.03). Patients with osteoporosis at femoral neck site had lower forced expiratory volume in 1 s (FEV(1) ) (p = 0.024), FEV(1) /forced vital capacity (FVC) (p < 0.0001), PEF (p = 0.008), and FEF 25-75 (p = 0.013) values compared with the patients with normal BMD z-scores. Low serum 25(OH) vitamin D levels were detected in 13/22 patients and low dietary calcium intake in 17/22 patients. BMD z-scores at femoral neck were lower in patients with low B-cell percentage (p = 0.03). BMD z-score at lumbar spine was correlated with folate (r = +0.63, p = 0.004) and serum immunoglobulin G levels (r = +0.430, p = 0.04).
CONCLUSION: Osteoporosis appeared as an emerging health problem of patients with CVID, the risk increasing with older age and poorer lung function. Nutritional, biochemical, and immunologic factors appeared to take part in decreased BMD. Insight into the mechanisms of osteoporosis in CVID is crucial to develop preventive strategies.
Safa Baris; Ahmet Ozen; Hulya Ercan; Elif Karakoc-Aydiner; Hasret Cagan; Cevdet Ozdemir; Metin Barlan; Nerin N Bahceciler; Isil B Barlan
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Publication Detail:
Type:  Journal Article     Date:  2011-06-06
Journal Detail:
Title:  Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology     Volume:  22     ISSN:  1399-3038     ISO Abbreviation:  Pediatr Allergy Immunol     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-09-28     Completed Date:  2012-01-12     Revised Date:  2012-04-26    
Medline Journal Info:
Nlm Unique ID:  9106718     Medline TA:  Pediatr Allergy Immunol     Country:  England    
Other Details:
Languages:  eng     Pagination:  676-83     Citation Subset:  IM    
Copyright Information:
© 2011 John Wiley & Sons A/S.
Division of Pediatric Allergy and Immunology, Marmara University, Istanbul, Turkey.
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MeSH Terms
Absorptiometry, Photon
Bone Density
Bone Diseases, Metabolic / complications,  epidemiology,  radiography
Bronchiectasis / complications,  immunology
Child, Preschool
Common Variable Immunodeficiency / complications*,  epidemiology,  immunology
Femur Neck / radiography
Osteoporosis / complications,  epidemiology,  radiography*
Respiratory Function Tests
Risk Factors
Young Adult
Comment In:
Pediatr Allergy Immunol. 2012 Mar;23(2):202-3; author reply 204   [PMID:  22432884 ]

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