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Severe osteopenia and vertebral compression fractures after complete remission in an adolescent with acute leukemia
Author(s) -
VassilopoulouSellin Rena,
Ramirez Irma
Publication year - 1992
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830390213
Subject(s) - medicine , osteopenia , bone resorption , prednisone , osteoporosis , acute lymphocytic leukemia , bone pain , leukemia , acute leukemia , surgery , bone mineral , gastroenterology , lymphoblastic leukemia
Acute leukemia frequently presents with skeletal symptoms; however, the etiologies of bone pain and osteopenia are poorly understood. We present the case of an adolescent girl with acute leukemia who developed vertebral fractures after being in complete remission for 3 months. Bone mineral density was very low (<0.6 g/cm 2 ) but remained stable during the subsequent 3 months despite continuation therapy with methotrexate and prednisone. Findings of a bone biopsy were consistent with a recent episode of aggressive bone resorption. We suggest that paracrine secretion of lymphokines may mediate loss of bone mass during the active phase of acute leukemia, although clinical bone disease may not develop until after complete remission is achieved.