ABSTRACT
Objective: To assess the impact of systemic corticosteroid therapy (SCT) indicated in the treatment of diffuse infiltrating lung disease (DILD) on the BMD assessed by bone densitometry Methods: Prospective study conducted in the pneumology department of Mongi Slim-La Marsa Hospital for one year (2019), involving patients with DILD in whom SCT was indicated in association with preventive measures (calcium and vitamin D). After written consent, each patient had the first measurement of BMDbefore starting SCT and then a control measure between 6 and 12 months after the start of treatment Results: 28 patients were enrolled (medium age=55.8 y;sex ratio F/H=3.5). All had the first measure of BMD and only 12 had a control measure (interruption due to COVID-19 pandemic). In the remaining group, the DILD treated were related to sarcoidosis (n=4), idiopathic nonspecific interstitial lung disease (n=3), Gougerot Sjögren's syndrome (n=2), HSP (n=1), Myositis (n=1), and Systemic Lupus Erythematosus (n=1). The average dose of prescribed SCT was 0.75 mg/kg/d. Based on the measurement of the L1-L4 vertebrae, at the first measurement of the BMD, 4 patients had no abnormalities, 3 had osteopenia and 5 had osteoporosis while at the control measure, 3 patients had no abnormalities, 3 had osteopenia and 6 had osteoporosis. Based on the measurement of the right femur, at the first measurement of the BMD, 5 patients had no abnormalities, 5 had osteopenia and 2 had osteoporosis while at the control measure, 3 patients had no abnormalities, 6 had osteopenia and 3 had osteoporosis. This difference between initial and control BMD was significant for the measurement at the right femur (p=0.001). Age was correlated with the decline of BMD in the L1-L4 vertebrae (p=0.024) Conclusion: SCT is responsible for a significant decrease in BMD despite preventive measures, hence the importance of routine osteoporosis screening and collaborative management with rheumatologists.