Long‐term effects of high‐dose systemic corticosteroids on growth and bone mineral density in patients treated for childhood interstitial lung disease (chILD)

Background Children's interstitial lung disease (chILD) is a rare and potentially life‐threatening condition. For many chILD conditions, systemic corticosteroids (sCCS) are considered the primary treatment despite a broad spectrum of potential side effects. Aim We aimed to determine the long‐te...

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Bibliographic Details
Published in:Pediatric pulmonology 2024-04, Vol.59 (4), p.964-973
Main Authors: Ring, Astrid Madsen, Buchvald, Frederik F., Main, Katharina M., Oturai, Peter, Nielsen, Kim G.
Format: Article
Language:English
Subjects:
adolescent
Bone density
bone mineralization
child
Childhood
corticosteroids
growth and development
Lung diseases
prednisolone
side effect
Steroids
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Summary:Background Children's interstitial lung disease (chILD) is a rare and potentially life‐threatening condition. For many chILD conditions, systemic corticosteroids (sCCS) are considered the primary treatment despite a broad spectrum of potential side effects. Aim We aimed to determine the long‐term effects of sCCS treatment on growth, bone mineral density (BMD), and body composition after chILD. Materials and Methods This descriptive cross‐sectional single‐center study included patients diagnosed with chILD before the age of 18 years treated with sCCS in the period 1998–2020. Dual‐energy X‐ray absorptiometry, anthropometric measurements, bone age determination, and blood tests were performed in 53 (55% males) of 89 eligible patients. Results Median (range) age was 19.3 (6.4;30.7 years). Participants received a median (range) cumulative sCCS dose of 1144 (135; 6178) mg over a 2.0 (0.1; 13.8) years period and latest dose was administered 11.7 (1.2; 19.6) years before follow‐up. Mean delta height (height standard deviation scores [SDS] – target height SDS) was reduced at sCCS treatment initiation (mean: −0.55, 95% confidence interval [CI]: −0.91; −0.20, p 25% in males) was found in 58% of patients. Conclusion Long‐term treatment with sCCS did not cause significant long‐term reduction of height but showed subtle effects on fat mass percentage and BMD. Given the severity of chILD, the observed long‐term effects of sCCS on growth and BMD appear acceptable.
ISSN:8755-6863
1099-0496
DOI:10.1002/ppul.26858