Premium
Changes of mineral metabolism in juvenile chronic arthritis
Author(s) -
Tzoufi M,
SiamopoulouMavridou A,
Challa A,
Lapatsanis PD
Publication year - 1994
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1994.tb13215.x
Subject(s) - medicine , juvenile chronic arthritis , alkaline phosphatase , endocrinology , gastroenterology , arthritis , osteocalcin , bone remodeling , enzyme , biochemistry , chemistry
Thirty five children with ambulant JCA were studied to assess the biochemical parameters of bone metabolism. The mean age of the study group was 8.8±4.1 years and the mean duration of active disease 3.8±1.3 years. According to the onset of the disease the children belonged to the systemic (7), polyarticular (12) and pauciarticular type (16). All the patients were treated with NSAIDs. In addition the polyarticular group received either gold injections or D‐penicillamine and the systemic group, steroids for at least 3 months. Two groups of controls were studied. The first one included fifteen children without chronic arthritis or bone disease and the second, four children who were treated with corticosteroids for a variety of reasons. In the group with systemic JCA Se Pi (1.28±0.29 mmol/l) and renal phosphate reabsorption (TmP/GFR=1.07±0.18) were significantly lower than in the control groups (1.50±0.19; 1.54±0.25 mmol/l, p<0.01 and 1.35±0.18; 1.29+0.23 mmol/l GF, p<0.05). Also lower were serum alkaline phosphatase (58±16.4 versus 83±24.2 and 80±15.6 IU/l, p<0.05), osteocalcin (5.5±4.7 versus 11.0±4.5 and 10.0±5.7 ng/ml, p<0.05), 25OHD (15.6±4.9 versus 27.3±6.2 and20.6±9.8 ng/ml, p<0.001) and l,25(OH)2D (12.1±6.0 versus 20.9±11.0 and 27.6±3.2 pg/ml, p<0.05). In the other two groups of patients (polyarticular and pauciarticular) all the values were found to be in the normal range except for the concentration of 25OHD which was significantly lower (17.8±4.7 ng/ml, p<0.001) in the active group than in the patients in remission (27.0±7.1 ng/ml). Hypercalciuria (UCa/UCr>0.18 mg/mg and Ca excretion >4 mg/Kg/24h) was observed in 18% of JCA patients. In conclusion the children with systemic onset JCA seem to have a disturbance in bone and mineral metabolism. The activity of JCA appears to lead to lower levels of 250HD.