TY - JOUR
T1 - The metabolic bone disease of primary sclerosing cholangitis
AU - Hay, J. Eileen
AU - Lindor, Keith D.
AU - Wiesner, Russell H.
AU - Dickson, E. Rolland
AU - Krom, Ruud A.F.
AU - Larusso, Nicholas F.
PY - 1991/8
Y1 - 1991/8
N2 - The incidence and severity of osteopenic bone disease in primary sclerosing cholangitis is poorly defined. Clinical, biochemical and radiographic assessment and bone mineral density measurements of the lumbar spine were carried out in two groups of patients. Group 1 consisted of 30 patients with advanced primary sclerosing cholangitis; group 2 consisted of 18 patients with newly diagnosed primary sclerosing cholangitis. Only one patient had bone pain. All patients were normocalcemic; two had elevated serum parathormone levels. Fourteen patients (47%) from group 1 but no patients from group 2 had low serum 25‐hydroxyvitamin D levels. Mean bone mineral density was significantly reduced in group 1 patients (0.97 ± 0.04 gm/cm2) compared with age‐matched and sex‐matched controls (1.25 ± 0.01 gm/cm2, p < 0.0001), and in 15 patients (50%) bone mineral density was below the fracture threshold (0.98 gm/cm2). The bone mineral density in group 2 was not significantly different from controls, and no patient was below the fracture threshold. In neither group did bone mineral density correlate with serum bilirubin, 25‐hydroxyvitamin D, fecal fat excretion, previous drug therapy or the presence of chronic ulcerative colitis. Histomorphometrical examination of bone from four group 1 patients showed increased bone resorption, reduced bone formation, moderate‐to‐severe osteopenia and no osteomalacia. In conclusion, severe osteopenic bone disease is common in advanced primary sclerosing cholangitis and, like that seen in other cholestatis diseases, is consistent with osteoporosis. (HEPATOLOGY 1991;14:257–261.)
AB - The incidence and severity of osteopenic bone disease in primary sclerosing cholangitis is poorly defined. Clinical, biochemical and radiographic assessment and bone mineral density measurements of the lumbar spine were carried out in two groups of patients. Group 1 consisted of 30 patients with advanced primary sclerosing cholangitis; group 2 consisted of 18 patients with newly diagnosed primary sclerosing cholangitis. Only one patient had bone pain. All patients were normocalcemic; two had elevated serum parathormone levels. Fourteen patients (47%) from group 1 but no patients from group 2 had low serum 25‐hydroxyvitamin D levels. Mean bone mineral density was significantly reduced in group 1 patients (0.97 ± 0.04 gm/cm2) compared with age‐matched and sex‐matched controls (1.25 ± 0.01 gm/cm2, p < 0.0001), and in 15 patients (50%) bone mineral density was below the fracture threshold (0.98 gm/cm2). The bone mineral density in group 2 was not significantly different from controls, and no patient was below the fracture threshold. In neither group did bone mineral density correlate with serum bilirubin, 25‐hydroxyvitamin D, fecal fat excretion, previous drug therapy or the presence of chronic ulcerative colitis. Histomorphometrical examination of bone from four group 1 patients showed increased bone resorption, reduced bone formation, moderate‐to‐severe osteopenia and no osteomalacia. In conclusion, severe osteopenic bone disease is common in advanced primary sclerosing cholangitis and, like that seen in other cholestatis diseases, is consistent with osteoporosis. (HEPATOLOGY 1991;14:257–261.)
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U2 - 10.1002/hep.1840140209
DO - 10.1002/hep.1840140209
M3 - Article
C2 - 1860683
AN - SCOPUS:0025880278
SN - 0270-9139
VL - 14
SP - 257
EP - 261
JO - Hepatology
JF - Hepatology
IS - 2
ER -