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Bleeding disorders and reduced bone density

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Abstract

In recent decays, quality of life and life expectancy of individuals with severe haemophilia A and B have been improved by better quality in treatment and more availability of blood coagulation products. Recently, new concerns have emerged in current groups such as auto-antibody inhibitors to coagulation factors and reduced bone density (RBD). RBD in bleeding disorders is becoming an escalating burden worldwide due to an increased in life expectancy and also in the ageing population with bleeding disorders. Here, we review published papers on bone mineral density of individuals with haemophilia A & B, a rare bleeding disorder entitled combined factor V and VIII deficiency and other rare bleeding disorders. It seems in individuals with bleeding disorders preventive measures including early detection, treatment and adequate physical activity, encouragement to be active in sports and finally anti-osteoporotic therapy must be done.

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References

  1. Heaney RP (2005) BMD: the problem. Osteoporos Int 16:1013–1015

    Article  PubMed  Google Scholar 

  2. Kovacs CS (2008) Hemophilia, low bone mass, and osteopenia/osteoporosis. Transfus Apher Sci 38(1):33–40

    Article  PubMed  Google Scholar 

  3. Khawaji M, Akesson K, Berntorp E (2009) Long-term prophylaxis in severe haemophilia seems to preserve bone mineral density. Haemophilia 15:261–266

    Article  CAS  PubMed  Google Scholar 

  4. Mansouritorghabeh H, Rezaieyazdi Z, Badiei Z (2008) Are individuals with haemophilia A prone to reduced bone density? Rheumatol Int 1079–1083

  5. Barnes C, Wong P, Egan B, Speller T, Cameron F, Jones G, Ekert H, Monagle P (2004) Reduced bone density among children with severe hemophilia. Pediatrics 114:177–181

    Article  Google Scholar 

  6. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and therapy (2001) Osteoporosis prevention, diagnosis, and therapy. JAMA 285:785–795

    Article  Google Scholar 

  7. Gerstner G, Damiano ML, Tom A, Worman C, Schultz W, Recht M, Stopeck AT (2009) Prevalence and risk factors associated with decreased bone mineral density in patients with haemophilia. Haemophilia 15:559–565

    Article  CAS  PubMed  Google Scholar 

  8. Cummings SR, Melton LJ (2002) Epidemilogy and outcomes of osteoporotic fractures. Lancet 1761–1767

  9. Voskaridou E, Christoulas D, Xirakia C, Varvagiannis K, Boutsikas G, Bilalis A, Kastritis E, Papatheodorou A, Terpos E (2009) Serum Dickkopf-1 increased and correlates with reduced bone mineral density in patients with thalassemia-induced osteoporosis. Reduction post-zoledronic acid administration. Haematol 94(5):123–126

    Google Scholar 

  10. Modaresi AR, Mansouritorghabeh H, Pourfathollah AA, Shooshtari MM, Yazdi ZR (2006) Pattern of factor VIII inhibitors in patients with hemophilia A in the north eastern Iran. Hematology 11(3):215–217

    Article  CAS  PubMed  Google Scholar 

  11. Mansouritorghabeh H, Rezaieyazdi Z, Nayyereh S, Saghafi M, Mirfeizi Z, Rezaie J (2009) Reduced bone density in individuals with haemophilia B. Int J Rheum Dis 12(2):125–129

    Article  PubMed  Google Scholar 

  12. Wallny TA, Scholz DT, Oldenberg J, Nicolay C, Ezziddin S, Pennekamp PH, Stoffel-Wagner B, Kraft CN (2007) Osteoporosis in haemophilia-an underestimated comorbidity? Haemophilia 13:79–84

    Article  CAS  PubMed  Google Scholar 

  13. Nair AP, Jijina F, Ghosh K et al (2007) Osteoporosis in young haemophiliacs from western India. Am J Hematol 82:453–457

    Article  PubMed  Google Scholar 

  14. Gallacher SJ, Deighan C, Wallace AM, Cowan RA, Fraser WD, Fenner JA, Lowe GD, Boyle IT (1994) Association of severe haemophilia A with osteoporosis: a densitometric and biochemical study. Q J Med 87:181–186

    CAS  PubMed  Google Scholar 

  15. Abdelrazik N, Mohammed R, Magdy E, Hala R (2007) Evaluation of bone mineral density in children with hemophilia: Mansoura University children hospital (MUCH) experience, Mansoura, Egypt. Hematol 12(5):431–437

    Article  Google Scholar 

  16. Rodrigues-Merchan EC (2002) Bone fractures in haemophilic patient. Haemophilia 8:104–111

    Article  Google Scholar 

  17. Tlacuilo-Parra A, Morales-Zambrano R, Tostado-Rabago N et al (2008) Inactivity is a risk factor for low bone mineral density among haemophilic children. Br J Haematol 140:562–567

    Article  PubMed  Google Scholar 

  18. Katsarou O, Terpos E, Chatzismalis P, Provelengios S, Adraktas T, Hadjidakis D, Kourammba A, Karafoulidou A (2009) Increased bone resorption is implicated in the pathogenesis of bone loss in hemophiliacs: correlation with hemophilic arthropathy and HIV infection. Ann Hematol doi:10.1007/s0027-0759-x

  19. Mansouritorghabeh H, Rezaieyazdi Z, Rezai J (2007) Reduced bone density in individuals with combined factor V and VIII deficiency. Haemophilia 13:340–343

    Article  CAS  PubMed  Google Scholar 

  20. Welton DC, Kemper HC, Post GB, Van Mechelen W, Twisk J, Lips P, Teule GJ (1994) Weight bearing activity during youth is more important factor for peak bone mass than calcium intake. J Bone Miner Res 9:1089–1096

    Article  Google Scholar 

  21. Davies JH, Evans BA, Gegory JW (2005) Bone mass acquisition in healthy children. Arch Dis Child 90:373–378

    Article  CAS  PubMed  Google Scholar 

  22. Lee VN, Sirvastava A, Nithyananth M, Kumar P, Cherian VM, Viswabandya A, Mathews V, George B, Venkatesh K, Nair SC, Chandy M, Sundararai GD (2007) Fracture neck of femur in haemophilia A—experience from a cohort of 11 patients from tertiary centre in India. Haemophilia 13:391–394

    Article  CAS  PubMed  Google Scholar 

  23. Scutellari PN, Orzincolo C, Franceschini F (1993) The hand in hematologic diseases. Minerva Med 84(10):511–521

    CAS  PubMed  Google Scholar 

  24. Hoots WK, Rodrigues N, Boggio L, Valentino LA (2007) Pathogenesis of haemophilic synovitis: clinical aspects. Haemophilia 13(3):4–9

    Article  CAS  PubMed  Google Scholar 

  25. Ljung R, Aronis-Vournas S, Kurnik-Auberger K et al (2000) Treatment of children with haemophilia in Europe: a survey of 20 centers in 16 countries. Haemophilia 6:619–624

    Article  CAS  PubMed  Google Scholar 

  26. Moore AL, Vashisht A, Sabin CA, Mocroft A, Madge S, Phillips AN, Studd JW, Johnson MA (2001) Reduced bone mineral density in HIV-positive individuals. AIDS 15:1731–1733

    Article  CAS  PubMed  Google Scholar 

  27. Gurevitch O, Slavin S (2006) The hematological etiology of osteoporosis. Med Hypothesis 67(4):729–735

    Article  Google Scholar 

  28. Voskaridou E, Terpos E (2004) New insights into the pathophysiology and management of osteoporosis in patients with beta thalassemia. Br J Haematol 127:127–139

    Article  CAS  PubMed  Google Scholar 

  29. van Rijn RR, van der Sluis IM, Link TM, Grampp S, Guglielmi G, Imhof H, Gluer C, Admas JE, van Kuijk C (2003) Bone densitomery in children: a critical appraisal. Eur Radiol 13:700–710

    PubMed  Google Scholar 

  30. McClung MR, Lewiecki EM, Cohen SB (2006) Denosumab in post menopausal women with low bone mineral density. N Engl J Med 354:821–831

    Article  CAS  PubMed  Google Scholar 

  31. Khosla S, Burr D, Cauley J (2007) Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American society for bone and mineral research. J Bone Miner Res 22:1479–1491

    Article  PubMed  Google Scholar 

  32. Ahnstrom J, Berntrop E, Lindvall K (2004) A 6-year follow-up of dosing, coagulation factor levels and bleedings in relation to joint status in the prophylactic treatment of haemophilia. Haemophilia 10:689–697

    Article  CAS  PubMed  Google Scholar 

  33. Bradney M, Pearce G, Naughton G (1998) Moderate exercise during growth in prepubertal boys: changes in bone mass, size, and bone strength: a controlled prospective study. J Bone Miner Res 13:1814–1821

    Article  CAS  PubMed  Google Scholar 

  34. Khawaji M, Astermark J, Akesson K, Berntorp E (2010) Physical activity for prevention of osteoprosis in patients with severe haemophilia on long-term prophylaxis. Haemophilia 1–7. doi: 10.1111/j.1365-2516.2009.02186.x

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Conflict of interest statement

There are no interests that might be distinguished as bias or poising a conflict for current review.

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Authors and Affiliations

  1. Immunology Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, 91766-99199, Mashhad, Iran

    Hassan Mansouritorghabeh

  2. Rheumatic Diseases Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

    Zahra Rezaieyazdi

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  1. Hassan Mansouritorghabeh
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  2. Zahra Rezaieyazdi
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Correspondence to Hassan Mansouritorghabeh.

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Mansouritorghabeh, H., Rezaieyazdi, Z. Bleeding disorders and reduced bone density. Rheumatol Int 31, 283–287 (2011). https://doi.org/10.1007/s00296-010-1534-y

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  • DOI: https://doi.org/10.1007/s00296-010-1534-y

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