Session 5: Osteoporosis

Abstract

Severe autoimmune rheumatic diseases, such as SLE and RA, occur more frequently in females, who are more prone than males to develop osteoporosis. Local and systemic inflammation are characteristic features of these diseases. Cytokines and prostaglandins, which are released and play key roles in the inflammatory and autoimmune processes involved. may also affect bone metabolism and contribute to osteoporosis.

Often rheumatic diseases affect and damage joints causing limitation of motion, thus creating the conditions for further development of osteoporosis.

Some inflammatory rheumatic diseases are managed with corticosteroids, methotrexate and other immunosuppressive medications. These therapeutic interventions, especially high dose and long term corticosteroids. are among the major risk factors for the development of osteoporosis in patients with rheumatic diseases.

In addition, certain patients with severe inflammatory incurable rheumatic disease may have been told to try a milk and dairy food free diet in hopes of combating their disease. However, the resulting reduced intake of calcium may contribute to the development of osteoporosis. Others, with autoimmune conditions, may avoid estrogen replacement therapy.

In our times, when new modalities are available for preventing or decreasing the severity of osteoporosis. it is important to increase alertness to risk factors for the development of osteoporosis in rheumatic diseases, which unfortunately are both numerous and real.