RESUMO
Dual energy X-ray absorptiometry [DEXA] is the most widely employed technique for diagnostic and serial assessment of bone mass. It is helpful in the investigation and follow up of children with diseases impairing bone metabolism like nephrotic syndrome. The aim of this work was to study the effect of long term steroid therapy on bone mineral density in corticosteroid responsive nephrotic children using DEXA. The study was conducted on 26 corticosteroid responsive nephrotic children in the age group 5-14 years with criteria of MCNS. Nephrotic patients were divided into group A [16 children with first attack or infrequent relapsers] and group B [10 children with steroid dependent NS]. Also, 10 healthy children were included as control. There was no statistically significant decrease of BMD at the end of steroid protocol used in patients with group A. During one year period of follow up of these patients only two cases relapsed which represents a relapse rate of 12.5%. On the contrary, there was a significant decrease in BMD in steroid dependent cases [group compared to control group. Also, there was a negative correlation between the cumulative dose of steroids and BMD
Conclusion: DEXA is a safe method to measure bone density in children. It should be used for assessment of BMD in nephrotic children under steroid therapy for long periods for early diagnosis and management of osteoporosis
RESUMO
This study was carried out on 20 patients with hyperthyroidism. The diagnosis of hyperthyroidism was based on clinical, biochemical and isotopic studies. Sixteen patients were diagnosed as Gravs' disease and four patients as toxic nodular goiter [two had solitary hot nodule and two had multinodular goiter], Thyroid stimulating immunoglobulin estimation revealed normal levels in all patients with toxic nodular goiter; while-13-patients [81%] with Gravs' disease showed high level of thyroid stimulating immunoglobulin. Six months after radioactive iodine therapy, all patients with previously high levels of thyroid stimulating immunoglobulin showed reduction in their serum levels to reach a normal value in 6 of them [46%] and levels above normal range in 7 [54%]. This finding suggests that radioactive iodine therapy may have an immunoregulatory effect in cases of Gravs' disease