Hepatic osteodystrophy:
literature review and report of a personal experience with children and adolescents with chronic cholestasis
DOI:
https://doi.org/10.22491/2357-9730.125023Keywords:
Hepatic osteodystrophy, cholestatic osteopenia, chronic liver diseaseAbstract
Hepatic osteodystrophy is the term used to define the metabolic bone disease
associated with chronic liver disease. It has been studied mainly in adults with chronic
cholestasis, but it is equally prevalent in children and adolescents. The pathogenesis
of hepatic osteodystrophy is unknown, however, it is likely to be multifactorial. The
majority of patients experience a progressive loss of bone mineral density, which causes
skeletal fragility. Thus, patients are predisposed to loss of height, to bone pain, and to
fracturing bones with minimal or no trauma. Bone mineral density may be measured
by dual photon absorptiometry. No specific therapy is available to treat or prevent the
osteopenia of chronic liver disease. However, 1 year after liver transplant, most patients
do regain bone mass. This review discusses the pathophysiology, diagnosis, and
treatment of hepatic osteodystrophy. In this review we also report our personal experience with 20 children and adolescents with chronic cholestasis receiving care at
the Pediatric Gastroenterology Unit at Hospital de Clínicas de Porto Alegre.
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