Información del artículo
La osteoporosis se define como una enfermedad esquelética sistémica caracterizada por masa ósea disminuida y deterioro de la microarquitectura del tejido óseo, con el consiguiente aumento de la fragilidad del hueso y la susceptibilidad a las fracturas. Se denomina osteoporosis primaria a la que acontece durante el período de envejecimiento fisiológico y, en la mujer, a la pérdida ósea relacionada con la menopausia. La osteoporosis secundaria es la que aparece por otros desórdenes o tras la toma de fármacos.
La osteoporosis secundaria al tratamiento con glucocorticoides u osteoporosis inducida por glucocorticoides (OIG) es la forma más frecuente de osteoporosis inducida por fármacos, y la segunda en frecuencia tras la osteoporosis posmenopáusica. Se ha estimado que más del 50% de los consumidores crónicos de glucocorticoides desarrollarán pérdida de masa ósea que conduzca a la fractura. Mediante la presentación de un caso clínico de OIG se repasan los aspectos aún controvertidos, como la etiopatogenia, los métodos de diagnóstico y las medidas dirigidas a su prevención y su tratamiento.
Palabras clave:
Osteoporosis
Glucocorticoides
Bifosfonatos
Densitometría mineral ósea
Osteoporosis is defined as a skeletal systemic disease characterized by reduced bone mass and deterioration of bone tissue microarchitecture, leading to increased bone fragility and susceptibility to fracture. Primary osteoporosis refers to osteoporosis occurring during the period of physiologic aging and, in women, to bone loss related to menopause.
Secondary osteoporosis is caused by another medical condition or by drugs. Glucocorticoid-induced osteoporosis (GIOP) is the second in frequency only after the osteoporosis that occurs after menopause and is the most common form of drug-induced osteoporosis. It is estimated that over 50% of chronic glucocorticoid users will develop bone loss leading to fracture. We use a case of GIOP to review areas of continued controversy, including the pathogenesis of GIOP, methods for diagnosis of GIOP, and an evidence-based approach for both GIOP prevention and treatment.
Key words:
Osteoporosis
Glucocorticoids
Bifosfonates
Bone mineral density
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