Juvenile Rheumatoid Arthritis (JRA) can lead to secondary osteoporosis due to many reasons. The disease process itself can cause osteoporosis.
Cases of bone disease are increasing
Dr Shankar Kurpad: Osteoporosis literally means “porous bone”. osteoporosis It is a disease in which the bones gradually become weak. bone density And the mass starts decreasing. Due to weakening of bones, the risk of fracture increases even after a minor injury. In this disease, bone formation is less and bone loss is more. Osteoporosis is more common in older people, especially older women. However, sometimes osteoporosis can also occur in young children due to medical conditions or certain medications. This is called Juvenile Osteoporosis.
Bone formation begins slowly in children from infancy to early adulthood, usually peaking in the late 20s. Juvenile osteoporosis poses a serious long-term risk because it occurs during the bone-growing years in children and thereby reduces the peak bone mass achieved in the 20s.
Causes of osteoporosis in children:
Osteoporosis is rarely seen in children and adolescents and is usually caused by a medical disorder or the drugs used to treat it. This condition is called secondary osteoporosis. Sometimes, when no specific cause of osteoporosis is found, it is known as idiopathic osteoporosis. The various causes of osteoporosis in young children include:
• Consumption of certain medicines – Anti-seizure medications, Anti-Cancer drugs
• Not doing physical activity
• Vitamin D and calcium deficiency
• Excessive exercise (exercise) that can cause periods to stop (amenorrhea), sometimes seen in more athletic girls
• Diabetes Mellitus [टाइप I] or growth hormone problems
• Sitting in bad posture for long periods of time
• Other conditions causing limited mobility – cerebral palsy, muscular dystrophy, and spinal cord damage
• Multi-factorial, eg juvenile rheumatoid arthritis
Juvenile Rheumatoid Arthritis (JRA) can lead to secondary osteoporosis due to many reasons. The disease process itself can cause osteoporosis, especially near joints affected by arthritis. Medicines used to treat JRA can reduce bone mass – steroid medicines such as prednisone. Children with JRA have frequent episodes of fever, severe joint pain and malaise – which affects the child’s nutrition and exacerbates calcium and vitamin D deficiency. A child with JRA avoids physical activity because it increases their joint pain. Adequate intake of calcium and vitamin D along with physical activity is necessary to maintain bone mass and muscle strength, while poor nutrition and lack of physical activity affect normal bone development.
Balanced diet and regular exercise helps
To maintain healthy growth, children’s body needs nutritious balanced diet along with regular physical exercise. One of the most important things for children is healthy food. Awareness of parents and family members about nutrition and exercise helps children inculcate healthy eating and exercise habits, which benefits children throughout their life.
An important step is to focus on meeting the daily requirements of calcium along with protein. Outdoor physical activity has a double benefit, it not only promotes bone and muscle growth, but also provides vitamin D through exposure to sunlight.
Since osteoporosis is a condition in which less bone is formed than more is lost, there are some important ways to reduce bone loss and improve bone formation:
• Children need a lot of calcium and vitamin D because they are growing, and growing bones require more calcium, vitamin D, and protein. Milk and dairy products contain calcium in abundance. Include vegetables like beans and greens in their diet, as well as sprouted gram. Many vegetables, such as broccoli, spinach, mustard greens, turnip greens also contain a lot of calcium.
• Exercise is essential for building healthy bones. Apart from this, by doing jogging, soccer, basketball and weight lifting exercises, the bones become strong and dense. So. Being physically active is very important for the development of healthy bones in children.
• Research shows that eating a diet rich in fruits and vegetables can help keep bones healthy. Vitamin C and other micronutrients like magnesium are essential for building healthy bones during childhood.
Juvenile osteoporosis, if left untreated, can lead to loss of bone strength, and can lead to fractures with minor injuries. Mild decreases in bone density in childhood and conditions that prevent the attainment of a normal peak bone mass increase the risk of osteoporosis and osteoporotic fractures in later life. Therefore, it is important to find the potential risk factors for juvenile osteoporosis and treat them early and correctly.
(The author of this article is Consultant Orthopedician at Manipal Hospital Yeshwanthpur)
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