Impact of ovarian insufficiency on bone health in childhood cancer survivors: Two cases

• Published in: Bone (New York, N.Y.) N.Y.), 2024-01, Vol.178, p.116930, Article 116930
• Main Authors: He, Cara Y., Lee, Danielle J., Foster, Kayla L., Gordon, Catherine M.
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; Adolescence; Adolescent; Bone Density; Cancer Survivors; Cancer survivorship; Estrogen deficiency; Estrogens; Female; Follicle Stimulating Hormone; Humans; Hypogonadism; Low bone density; Neoplasms; Premature ovarian insufficiency; Primary Ovarian Insufficiency - complications; Primary Ovarian Insufficiency - diagnosis
• ISSN: 8756-3282; 1873-2763; 1873-2763
• DOI: 10.1016/j.bone.2023.116930

To investigate the skeletal phenotype of adolescent girls with premature ovarian insufficiency (POI). Data are presented from two adolescent girls who participated in a clinical research protocol to evaluate axial bone mineral density (BMD) (via dual-energy x-ray absorptiometry, DXA) and appendicular bone density, microarchitecture, and strength (via high-resolution peripheral quantitative computed tomography, HRpQCT). Anthropometric data were also obtained, and pubertal staging performed by a clinician. Both cases presented with undetectable estradiol concentrations, and evidence of an elevated follicle stimulating hormone, meeting the criteria for POI. Each also received alkylating agents as part of their chemotherapy and radiotherapy, but in different locations as one presented with stage IV neuroblastoma and the other, metastatic medulloblastoma. Both had a low BMD of the axial and appendicular skeleton, as well as microarchitectural changes of the latter. The low BMD Z-score (