Osteoporosis and bone health in pediatric patients with epidermolysis bullosa: A scoping review.
Study Goal
The researchers aimed to assess the current understanding and clinical practices for monitoring and treating osteoporosis in individuals with epidermolysis bullosa (EB), including the role of vitamin D supplementation.
Results Summary
The study found that vitamin D supplementation (80-320 IU daily for children 0-7 years and 720 IU for patients >8 years) is recommended as part of a broader strategy to manage bone health in EB patients, alongside nutritional assessments, bloodwork, and DEXA scans. The recommendations are based on a scoping review of 21 publications, with 13 providing specific guidelines.
Population
Individuals with epidermolysis bullosa (EB).
Effective Dosage
80-320 IU daily for children 0-7 years; 720 IU daily for patients >8 years.
Duration
Not specified.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
early nutritional and weight assessments | neutral | nutritional compromise | individuals with epidermolysis bullosa (EB) | before 2 years of age | recommended | #1 |
bloodwork | neutral | monitoring of osteoporosis | individuals with epidermolysis bullosa (EB) | every 6-12 months starting at birth | recommended | #2 |
Tanner stage assessments | neutral | pubertal delay | individuals with epidermolysis bullosa (EB) | every 6 months | recommended | #3 |
DEXA scans | neutral | osteoporosis | individuals with epidermolysis bullosa (EB) | starting at age 6 years with repeated scans every 1-2 years, except in mild cases | recommended | #4 |
vitamin D supplementation | neutral | bone health | children 0-7 years | 80-320 IU daily | recommended | #5 |
vitamin D supplementation | neutral | bone health | patients >8 years | 720 IU | recommended | #6 |
Nutritional compromise, low levels of vitamin D, chronic inflammation, abnormal growth, and physical inactivity affect bone metabolism and compromise long-term bone health in individuals with epidermolysis bullosa (EB). The result is a high risk for osteopenia, osteoporosis, and pathologic fractures, but this important consequence of EB has been the focus of few investigations. Our scoping review found 21 publications that assessed the current understanding and clinical practices for monitoring of osteoporosis and its treatment in EB. Recommendations summarized from 13 of these publications include early nutritional and weight assessments before 2 years of age; bloodwork every 6-12 months starting at birth; Tanner stage assessments every 6 months to detect any pubertal delay; DEXA scans starting at age 6 years with repeated scans every 1-2 years, except in mild cases; and vitamin D supplementation of 80-320 IU daily for children 0-7 years and 720 IU for patients >8 years.