Liver transplantation provides an important, often life-saving treatment for end-stage liver disease. Osteoporosis post-liver transplantation has been described in adults; however, this has not been described in the pediatric population to date. We present a case of a 13-year-old female patient who underwent an orthotopic liver transplant for cryptogenic liver cirrhosis. Her immunosuppressants were tacrolimus and prednisone. Four months posttransplant, she started complaining of bilateral lower limb pain and limping while walking, progressing to a point where she was almost immobile. Magnetic resonance imagining of the pelvis showed bilateral avascular necrosis involving the weight-bearing surfaces of both femoral heads, in addition to the extensive edema involving both hip joints. Bone mineral densitometry was below normal for her age at the hip and forearm. She was started on high-dose calcium and vitamin D supplement, as well as zoledronic acid with a remarkable symptomatic and functional improvement.

译文

肝移植为终末期肝病提供了重要的,通常挽救生命的治疗方法。已在成年人中描述了肝移植后的骨质疏松症; 但是,迄今为止,尚未在儿科人群中描述。我们介绍了一例13岁的女性患者,该患者因隐源性肝硬化接受了原位肝移植。她的免疫抑制剂是他克莫司和泼尼松。移植后四个月,她开始抱怨双侧下肢疼痛和走路时跛行,进展到几乎不动的地步。骨盆的磁共振成像显示双侧缺血性坏死涉及两个股骨头的承重表面,此外还涉及两个髋关节的广泛水肿。在臀部和前臂的年龄,骨矿物质密度低于正常水平。她开始服用大剂量钙和维生素d补充剂,以及唑来膦酸,症状和功能明显改善。

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