Reactions 1704, p215 - 2 Jun 2018 Osteopenia, height loss and non-traumatic compression fractures : case report A 19-year-old man developed osteopenia, height loss and non-traumatic compression fractures during treatment with ivacaftor/lumacaftor for cystic fibrosis. The man who had fat-soluble vitamin deficiency and osteopenia, was hospitalised for the treatment of a cystic fibrosis (CF) pulmonary exacerbation and a weight loss. He had been taking ivacaftor/lumacaftor [route and dosage not stated] for approximately 18 months for CF. On admission, a review of his growth chart showed a height loss of 8.5cm over the previous 5 months. One month before the admission, a dual energy X-ray absorption (DEXA) scan was significant for osteopenia. He was started on treatment for cystic fibrosis (CF) pulmonary exacerbation and was continued on ivacaftor/ lumacaftor. On further questioning, he reported a mild intermittent back pain over the previous six months. His musculoskeletal physical examination remained normal, except from the loss in height. A lumbar spine X-ray showed a superior end-plate fracture of L1 and a chest computed tomography scan showed the incidental finding of significant height loss of multiple mid-thoracic vertebrae. At follow-up, a total spine MRI revealed evidence of chronic compression fractures at the level of T5 through L1 [duration of treatment to reactions onset not stated]. The man was treated colecalciferol and pamidronic acid [outcomes not stated]. Author comment: "Lumacaftor/ivacaftor therapy was initiated in our patient approximately 18 months prior to his presentation." "[I]t is important to consider the possibility of this medication having an impact on bone health." Schendel A, et al. Unexpected Height Loss in an Adolescent With Cystic Fibrosis Global pediatric health 5: 1-4, 22 May 2018. Available from: URL: https:// dx.doi.org/10.1177/2333794X18773662 - USA 803323012 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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