Cushing’s syndrome, glucocorticoids and bone


Authors: Kršek Michal
Authors‘ workplace: II. interní klinika 3. LF UK a FN Královské Vinohrady, Praha
Published in: Clinical Osteology 2019; 24(2): 57-61
Category:

Overview

Cushing’s syndrome, both endogenous and exogenous (iatrogenic), is associated with a decrease of bone mass called as glucocorticoid-induced osteoporosis. Among factors playing role in its pathogenesis are: inhibition of bone formation and stimulation of osteoresorption, disturbed bone remodelation, disturbed calcium-phosphate metabolism with negative calcium balance and also disturbed vitamin D metabolism. Prevention of glucocorticoid-induced osteoporosis consists of identification of subjects at increased risk of fractures and introducing measures leading to its decrease. Therapy includes non-pharmacological measures and sufficient intake of calcium and vitamin D. As the first line in medical treatment are recommended bisphosphonates or teriparatide, after discontinuation of teriparatide bisphosphonates or denosumab.

Keywords:

osteoporosis – Cushing’s syndrome – glucocorticoids – treatment


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Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics General practitioner for adults Radiodiagnostics Rehabilitation Rheumatology Traumatology
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