소아청소년기 항암치료 후 최대 골량 형성 부전으로 저충격 골절을 보인 20대 여성
Multiple Insufficient Fractures in a Woman Who Failed to Achieve Peak Bone Mass after Cancer Therapy in Adolescence
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초록
소아 청소년기에 최대 골량 획득이 제대로 이루어 지지 못하면 조기에 골다공증이 발생하고 골절에 이르게 된다. 저자들은 소아종양 치료 후 최대 골량 획득에 실패하고 23세경에 저충격에 의한 다발성 골절을 보인 환자의 증례를 문헌 고찰과 함께 보고하는 바이다. 소아내분비 전문의는 항암 치료 후 장기 생존자에서 골다공증을 스크린하고 골 건강을 악화시킬 수 있는 위험요소를 찾아내며, 호르몬 보충요법과 비스포스포네이트 등을 통한 적절한 치료를 통해 장기 종양 생존자의 삶의 질을 높여야 할 것이다.
Abstract
A 23-year-old female was brought to our pediatric clinic complainting arm and back pain. The pain developed suddenly while she was on a roller coaster and she denied any history of injuries. At First, she visited local orthopedics, and a simple X-ray showed fracture in her left forearm. She received a cast therapy, and and after several months, the fracture lesion of forearm was improved. But the pain in her arm and back still remained. Eight years ago, she was diagnosed with rhabdomyosarcoma of the left forearm and received a combination of chemotherapy and radiotherapy. She was slightly built and became increasingly thinner over the course of, chemotherapy. After completing chemotherapy, she was evaluated for bone mineral density (BMD) and was found to be osteoporotic. She was advised to take calcium supplements and exercise regular, and was assesse for BMD annually, using a duel energy X-ray absorpometry (DXA). However, her BMD did not improve and she never achieved an adequate peak bone mass. This case showed that failure to gain adequate peak bone mass during growth did not result in a later increase in bone mass in the young adult period, and finally caused multiple insufficient fractures.
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