Source: Annual Congress 2002 - Miscellaneous respiratory infections in children
Disease area: Paediatric lung diseases

Abstract

Bronchiectasis is the final common pathway of different lower respiratory tract insults. Osteoporosis occurs in cystic fibrosis (CF) secondary to chronic use of systemic corticosteroids and poor clinical status. Although children with non-CF bronchiectasis carry similar risk factors, it is not known whether bone density is affected in these children. Speed of sound (SOS) measurement by quantitative ultrasonography is a useful method for assessing bone strength. We measured the radial and tibial SOS in 32 children (17 girls, age 12.5 ±]4.6 year) with non-CF bronchiectasis and age, sex, pubertal status matched healthy controls. Calcium intake was assessed by a 4 day nutritional diary. Pulmonary function tests and steroid use were noted. Thirteen non-CF bronchiectasis children had osteopenia (tibia or radius z-skor < -1.0) and 9 had osteoporosis (tibia or radius z-skor < -2.0). SOS of tibia and z-scores were significantly lower in non-CF bronchiectasis (p 0.04 and 0.02). Calcium intake was not different between the two groups. Six children had moderate to severe lung disease (FEV1<60%predicted). Children with lower FEV1 also had lower tibial bone density (r = -0.540, p=0.009). All except 2 children (94%) were receiving inhaled steroids and children who received higher cumulative steroid doses had lower radial bone density (r = -0.515, p=0.02). Therefore we conclude that children with non-CF bronchiectasis have low bone density which maybe related to the severity of the disease and steroid use. We suggest that these children should be closely monitored for osteoporosis.

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R. Hamutcu, S. Turan, T. Erdo[gu]an, F. Karakoc, S. Keskin, B. Karadag, A. Bereket, E. Dagli (Istanbul, Turkey). Evaluation of bone strength by quantitative ultrasound in children with non-cystic fibrosis bronchiectasis. Eur Respir J 2002; 20: Suppl. 38, 2107

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