Clinical case of secondary osteoporosis in patient with ulcerative colitis

Authors

DOI:

https://doi.org/10.14739/2310-1237.2020.3.221887

Keywords:

clinical case, osteoporosis, colitis

Abstract

 

The incidence and prevalence of chronic inflammatory diseases of the gastrointestinal tract has been steadily increasing recently in all regions of the world. Celiac disease, Crohn's disease and non-specific ulcerative colitis, among others, are diagnosed during the most productive period of life, which significantly limits its quality, as well as violate the patient's psycho-emotional state and social status. Among the intestinal manifestations of chronic diseases of the small and large intestine, the osteoporosis is most relevant, and associated with an increased risk of fractures.

Aim. To describe the clinical case of secondary osteoporosis in patient with a long course of nonspecific ulcerative colitis, to cover the problem of monitoring, treatment and possible solutions.

Results. The clinical case of development of severe secondary osteoporosis in a patient with non-specific ulcerative colitis is presented. Determinants of bone loss in this category of patients are chronic inflammation of the mucous membrane, impaired enteral absorption and glucocorticoid therapy. Current risk monitoring tools for osteoporosis in risk groups are the determination of individual risk of fractures FRAX®, regular clinical laboratory monitoring and densitometry. Current treatment of secondary osteoporosis should be personalized with proper control over the course of the underlying disease.

Conclusion. The described clinical case demonstrates a need for further population-based prospective studies to create diagnostic and therapeutic algorithms. These algorithms could help provide personalized therapy to patients with gastrointestinal diseases in group of osteoporosis and fractures risk at a young age.

 

References

National Center for Chronic Disease Prevention and Health Promotion. (2019). Inflammatory Bowel Disease (IBD). Centers for Disease Control and Prevention. http://www.cdc.gov/ibd/#epidIBD

Singh, P., Arora, A., Strand, T. A., Leffler, D. A., Catassi, C., Green, P. H., Kelly, C. P., Ahuja, V., & Makharia, G. K. (2018). Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis. Clinical gastroenterology and hepatology, 16(6), 823-836.e2. https://doi.org/10.1016/j.cgh.2017.06.037

Molodecky, N. A., Soon, I. S., Rabi, D. M., Ghali, W. A., Ferris, M., Chernoff, G., Benchimol, E. I., Panaccione, R., Ghosh, S., Barkema, H. W., & Kaplan, G. G. (2012). Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology, 142(1), 46-e30. https://doi.org/10.1053/j.gastro.2011.10.001

Dahlhamer, J. M., Zammitti, E. P., Ward, B. W., Wheaton, A. G., & Croft, J. B. (2016). Prevalence of Inflammatory Bowel Disease Among Adults Aged ≥18 Years - United States, 2015. MMWR. Morbidity and mortality weekly report, 65(42), 1166-1169. https://doi.org/10.15585/mmwr.mm6542a3

Tremaine W. J. (2011). Diagnosis and treatment of indeterminate colitis. Gastroenterology & hepatology, 7(12), 826-828.

Scott, E. M., Gaywood, I., & Scott, B. B. (2000). Guidelines for osteoporosis in coeliac disease and inflammatory bowel disease. British Society of Gastroenterology. Gut, 46 Suppl 1(Suppl 1), i1-i8. https://doi.org/10.1136/gut.46.suppl_1.i1

Povoroznyuk, V. V., Korzh, N. A., Kovalenko, V. N., Dedukh, N. V., Zupanets, I. A., Luk'yanova, E. M., Butenko, G. M., Chernykh, V. F., Ababkova, G. N., & Balaklitskaya, I. S. (2002). Osteoporoz: epidemiologiya, klinika, diagnostika, profilaktika i lechenie [Osteoporosis: epidemiology, clinic, diagnosis, prevention and treatment]. Khar'kov: Zolotye stranitsy. [in Russian].

Krela-Kaźmierczak, I., Szymczak, A., Łykowska-Szuber, L., Eder, P., & Linke, K. (2016). Osteoporosis in Gastrointestinal Diseases. Advances in clinical and experimental medicine, 25(1), 185-190. https://doi.org/10.17219/acem/33746

Fitzpatrick L. A. (2002). Secondary causes of osteoporosis. Mayo Clinic proceedings, 77(5), 453-468. https://doi.org/10.4065/77.5.453

Bernstein, C. N., Blanchard, J. F., Leslie, W., Wajda, A., & Yu, B. N. (2000). The incidence of fracture among patients with inflammatory bowel disease. A population-based cohort study. Annals of internal medicine, 133(10), 795-799. https://doi.org/10.7326/0003-4819-133-10-200011210-00012

Oh, H. J., Ryu, K. H., Park, B. J., & Yoon, B. H. (2018). Osteoporosis and Osteoporotic Fractures in Gastrointestinal Disease. Journal of bone metabolism, 25(4), 213-217. https://doi.org/10.11005/jbm.2018.25.4.213

Tilg, H., Moschen, A. R., Kaser, A., Pines, A., & Dotan, I. (2008). Gut, inflammation and osteoporosis: basic and clinical concepts. Gut, 57(5), 684-694. https://doi.org/10.1136/gut.2006.117382

Nebyl'tsova O. V. (Ed.). (2013). Laboratornyi spravochnik SINEVO. Ltd "Doctor Media". [in Russian].

Centre for Metabolic Bone Diseases (n.d.). FRAX ® Fracture Risk Assessment Tool for Ukrainian population. Questionnaire. Centre for Metabolic Bone Diseases, University of Sheffield. https://www.sheffield.ac.uk/FRAX/tool.aspx?country=66

Kanis, J. A., Burlet, N., Cooper, C., Delmas, P. D., Reginster, J., Borgstrom, F., & Rizzoli, R. (2008). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis International, 19(4), 399-428. https://doi.org/10.1007/s00198-008-0560-z

Coleman, R., Body, J. J., Aapro, M., Hadji, P., Herrstedt, J., & ESMO Guidelines Working Group (2014). Bone health in cancer patients: ESMO Clinical Practice Guidelines. Annals of oncology, 25 Suppl 3, iii124-iii137. https://doi.org/10.1093/annonc/mdu103

Buckley, L., Guyatt, G., Fink, H. A., Cannon, M., Grossman, J., Hansen, K. E., … McAlindon, T. (2017). 2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Arthritis & rheumatology, 69(8), 1521-1537. https://doi.org/10.1002/art.40137

Müller, F., Appelt, K. A., Meier, C., & Suhm, N. (2020). Zoledronic acid is more efficient than ibandronic acid in the treatment of symptomatic bone marrow lesions of the knee. Knee surgery, sports traumatology, arthroscopy, 28(2), 408-417. https://doi.org/10.1007/s00167-019-05598-w

Dhillon S. (2016). Zoledronic Acid (Reclast®, Aclasta®): A Review in Osteoporosis. Drugs, 76(17), 1683-1697. https://doi.org/10.1007/s40265-016-0662-4

Bleicher, K., Naganathan, V., Cumming, R. G., Seibel, M. J., Sambrook, P. N., Blyth, F. M., Le Couteur, D. G., Handelsman, D. J., Waite, L. M., & Creasey, H. M. (2010). Prevalence and treatment of osteoporosis in older Australian men: findings from the CHAMP study. The Medical journal of Australia, 193(7), 387-391.

Modi, A., Sajjan, S., Michael Lewiecki, E., Harris, S. T., & Papadopoulos Weaver, J. (2016). Relationship Between Gastrointestinal Events and Compliance With Osteoporosis Therapy: An Administrative Claims Analysis of the US Managed Care Population. Clinical therapeutics, 38(5), 1074-1080. https://doi.org/10.1016/j.clinthera.2016.03.027

Lindsay, R., Krege, J. H., Marin, F., Jin, L., & Stepan, J. J. (2016). Teriparatide for osteoporosis: importance of the full course. Osteoporosis international, 27(8), 2395-2410. https://doi.org/10.1007/s00198-016-3534-6

Zaheer, S., LeBoff, M., & Lewiecki, E. M. (2015). Denosumab for the treatment of osteoporosis. Expert opinion on drug metabolism & toxicology, 11(3), 461-470. https://doi.org/10.1517/17425255.2015.1000860

Anastasilakis, A. D., Polyzos, S. A., & Makras, P. (2018). Therapy of endocrine disease: Denosumab vs bisphosphonates for the treatment of postmenopausal osteoporosis. European journal of endocrinology, 179(1), R31-R45. https://doi.org/10.1530/EJE-18-0056

How to Cite

1.
Zhuravlyova LV, Sikalo YK, Oliinyk MO. Clinical case of secondary osteoporosis in patient with ulcerative colitis. Pathologia [Internet]. 2020Dec.29 [cited 2024Dec.23];(3). Available from: http://pat.zsmu.edu.ua/article/view/221887

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Section

Case Reports