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Osteoporosis and bone health in pediatric patients with epidermolysis bullosa: A scoping review.

Pediatric dermatology
January 1, 2024
Andie Kwon et al. (5 authors)
Journal ArticleScoping ReviewHuman Study
Study Details

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.

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
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
Abstract

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.

Medical Subject Headings (MeSH)
HumansChildEpidermolysis BullosaOsteoporosisChild, PreschoolInfantBone DensityAdolescent
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations1
Citations/Year1.0
Research Impact Scores
APT Score0.25
Weight Score2.60
Normalized Score0.66
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