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Antiepileptic Medications Increase Osteoporosis Risk in Male Fabry Patients: Bone Mineral Density in an Australian Cohort.
[fabry disease]
Background
:
Fabry
disease
(
FD
)
is
an
inherited
X-
linked
lysosomal
storage
disease
with
widespread
clinical
manifestations
.
Small
prospective
studies
have
shown
increased
osteopenia
and
osteoporosis
in
male
FD
patients
.
Limited
information
however
exists
about
bone
metabolism
and
osteoporosis
risk
factors
within
this
group
.
We
reviewed
osteoporosis
risk
factors
within
our
cohort
.
Methods
:
A
retrospective
analysis
of
bone
mineral
density
(
BMD
)
results
and
fracture
incidence
in
44
patients
(
22
males
and
22
females
)
was
undertaken
.
Dual
X-
ray
absorptiometry
scans
were
performed
at
the
lumbar
spine
,
hip
and
femoral
neck
.
The
impact
of
risk
factors
including
renal
function
,
antiepileptic
drug
(
AED
)
,
analgesia
and
vitamin
D
levels
were
assessed
.
Results
:
Male
FD
patients
had
low
T
scores
at
all
sites
(
spine
-
1
.
2
±
1
.
06
,
hip
-
1
.
6
±
0
.
9
,
femoral
neck
-
2
.
23
±
1
.
01
)
.
Female
T
scores
showed
more
typical
distribution
(
spine
-
0
.
07
±
1
.
47
,
hip
0
.
02
±
1
.
14
,
femoral
neck
-
0
.
49
±
1
.
31
)
.
A
higher
incidence
of
osteopenia
and
/
or
osteoporosis
occurred
in
males
versus
females
(
spine
46
.
9
%
versus
31
.
8
%
,
hip
75
.
5
%
versus
18
.
2
%
and
femoral
neck
86
.
4
%
versus
45
.
5
%
)
.
Multiple
regression
analysis
showed
a
50
.
8
%
(
p
<
0
.
001
)
reduction
in
femoral
neck
BMD
with
AED
usage
,
after
adjustment
for
age
,
gender
and
renal
function
.
Non-traumatic
fractures
occurred
in
27
.
3
%
males
over
205
patient-
years
versus
4
.
6
%
in
females
over
149
patient-
years
,
p
=
0
.
095
.
Conclusions
:
Low
bone
density
was
highly
prevalent
in
male
patients
with
increased
incidence
of
non-traumatic
fractures
.
AED
usage
significantly
reduces
BMD
.
Treatment
to
prevent
BMD
deterioration
willdepend
on
determining
the
bone
turnover
status
.
Diseases
Validation
Diseases presenting
"osteoporosis"
symptom
achondroplasia
adrenal incidentaloma
allergic bronchopulmonary aspergillosis
aromatase deficiency
congenital adrenal hyperplasia
cushing syndrome
cutaneous mastocytosis
dentinogenesis imperfecta
erythropoietic protoporphyria
fabry disease
familial hypocalciuric hypercalcemia
familial mediterranean fever
inclusion body myositis
kallmann syndrome
oligodontia
pyomyositis
werner syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated