Organ transplantation and osteoporosis.

Abstract:

:Organ transplantation offers new life to patients who suffer from incurable disease. The problem of rejection of the transplanted organ has been overcome with the use of potent immunosuppressive drugs. These drugs, although they allow graft tolerance and graft survival, also are associated with complications such as osteoporosis. Although factors such as nutrition, gonadal status, and ambulatory status are important, the use of immunosuppressive drugs appears to be the main factor in the development of osteoporosis. The drugs that are responsible for this bone loss are glucocorticoids and the calcineurin phosphatase inhibitors, cyclosporine and tacrolimus. The incidence of bone disease depends, in part, on which organ is transplanted. Kidney transplant recipients appear to be less susceptible to the development of overt osteoporosis than do heart or liver transplant recipients. The most critical period of bone loss in organ recipients appears to be within the first 6 months, with the most dramatic reduction occurring within the first 3 months following transplantation. Trabecular (cancellous) bone of the spine appears to be most at risk, with vertebral fractures occurring most commonly. Transplant recipients should be evaluated by bone mineral densitometry and measurement of vitamin D metabolites, blood urea nitrogen, creatinine, calcium, and phosphate. Markers of bone turnover may help in assessing the rate of remodeling. Gonadal function should be ascertained by measurement of serum testosterone (males) or estradiol (females) levels. Therapy should be directed toward prevention of bone loss as well as helping to restore what already may have been lost. Administration of calcium and vitamin D and sex hormone replacement, if indicated, should be considered.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

Curr Opin Rheumatol

authors

Epstein S,Shane E,Bilezikian JP

doi

10.1097/00002281-199505000-00018

subject

Has Abstract

pub_date

1995-05-01 00:00:00

pages

255-61

issue

3

eissn

1040-8711

issn

1531-6963

journal_volume

7

pub_type

杂志文章,评审
  • Achilles tendon injuries.

    abstract::The Achilles tendon is the strongest tendon in the human body. Because most Achilles tendon injuries take place in sports and there has been an common upsurge in sporting activities, the number and incidence of the Achilles tendon overuse injuries and complete ruptures have increased in the industrialized countries du...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-200103000-00009

    authors: Järvinen TA,Kannus P,Paavola M,Järvinen TL,Józsa L,Järvinen M

    更新日期:2001-03-01 00:00:00

  • Juvenile onset spondyloarthropathies.

    abstract::Refinement of criteria for classifying childhood rheumatic diseases has contributed to earlier, more complete, and more precise diagnosis of children with spondyloarthropathies. Recent additions to the literature have contributed new international perspectives relating to the prevalence of juvenile spondyloarthropathi...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-200009000-00013

    authors: Rosenberg AM

    更新日期:2000-09-01 00:00:00

  • Signal transduction in rheumatoid arthritis.

    abstract:PURPOSE:Signal transduction pathways are the intracellular mechanism by which cells respond and adapt to environmental stress. Understanding the critical networks in diseases like rheumatoid arthritis can potentially identify novel therapeutic targets. RECENT FINDINGS:Dissecting the complex pathways involved in rheuma...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-200405000-00011

    authors: Sweeney SE,Firestein GS

    更新日期:2004-05-01 00:00:00

  • New developments in our understanding of DISH (diffuse idiopathic skeletal hyperostosis).

    abstract:PURPOSE OF REVIEW:Diffuse idiopathic skeletal hyperostosis (DISH) or Forestier's disease is a common disorder among older adults. The diagnosis is based solely on radiographic abnormalities defined using the Resnick criteria. DISH is characterized by ossification of the anterior longitudinal ligament of the spine and v...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-200405000-00021

    authors: Sarzi-Puttini P,Atzeni F

    更新日期:2004-05-01 00:00:00

  • The epidemiology of osteoarthritis of the knee.

    abstract::Estimates of the prevalence and incidence of knee osteoarthritis increase with age and are higher for women. Other differences in such estimates arise due to methodologic variables, including radiographic techniques. The risk for knee osteoarthritis increases with increasing body weight, long-term occupational joint s...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:

    authors: Slemenda CW

    更新日期:1992-08-01 00:00:00

  • Usefulness of PET in recognizing and managing vasculitides.

    abstract:PURPOSE OF REVIEW:The aim of this article was to review the recent contributions to the scoring methods of PET in vasculitis as well as to its role in the diagnostic work-up. RECENT FINDINGS:Both visual and semiquantitative scoring methods can be used to interpret PET scans. PET has been shown to be both sensitive and...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/BOR.0000000000000459

    authors: Pipitone NAM,Versari A,Salvarani C

    更新日期:2018-01-01 00:00:00

  • HLA-B27 structure, function, and disease association.

    abstract::The polymorphism of HLA-B27 alleles is located in the peptide-anchoring motif. In recent years, fundamental insights have been made into the molecular aspects of HLA-B27-restricted presentation. Subtle differences in peptide binding fine specificity are especially interesting for closely related HLA-B27 alleles that h...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-199607000-00005

    authors: López-Larrea C,Gonzalez-Roces S,Alvarez V

    更新日期:1996-07-01 00:00:00

  • Clinical and pathologic aspects of arthritis due to Ross River virus and other alphaviruses.

    abstract:PURPOSE OF REVIEW:Arthritogenic alphaviruses are globally distributed mosquito-borne RNA viruses causing epidemics of polyarthritis/arthralgia, with disease emerging or reemerging and increasingly being reported in travelers. This article summarizes the current knowledge of these diseases, focusing on recent developmen...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/01.bor.0000130537.76808.26

    authors: Suhrbier A,La Linn M

    更新日期:2004-07-01 00:00:00

  • Autoimmune pancreatitis and IgG4-related sclerosing cholangitis.

    abstract:PURPOSE OF REVIEW:Autoimmune pancreatitis (AIP) is a peculiar type of pancreatitis with a presumed autoimmune etiology. AIP is frequently associated with stenosis of the bile duct in the form of IgG4-related sclerosing cholangitis. This article reviews recent advances in clinicopathological findings for AIP and IgG4-re...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/BOR.0b013e3283412f60

    authors: Takuma K,Kamisawa T,Igarashi Y

    更新日期:2011-01-01 00:00:00

  • Prediction of infection risk in rheumatoid arthritis patients treated with biologics: are we any closer to risk stratification?

    abstract:PURPOSE OF REVIEW:There are currently several available biologics for rheumatoid arthritis (RA) with similar efficacy in most trials. A major consideration therefore in choosing a biologic, continues to be safety concerns such as infection. Considerable advances have been made in the understanding of biologic safety on...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/BOR.0000000000000598

    authors: Jani M,Barton A,Hyrich K

    更新日期:2019-05-01 00:00:00

  • An update on IgG4-related disease.

    abstract:PURPOSE OF REVIEW:IgG4-related disease (IgG4-RD) is a recently described fibroinflammatory condition that can affect nearly any organ. Our knowledge of this condition--its manifestations, diagnosis, pathogenesis and treatment--is expanding rapidly. RECENT FINDINGS:This review highlights the most recent developments in...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/BOR.0000000000000133

    authors: Wallace ZS,Stone JH

    更新日期:2015-01-01 00:00:00

  • The effect of autoimmune arthritis treatment strategies on regulatory T-cell dynamics.

    abstract:PURPOSE OF REVIEW:Since their discovery over 15 years ago, intensive research has focused on the presence, phenotype and function of FOXP3(+) regulatory T cells (Treg) in autoimmune diseases such as rheumatoid arthritis (RA). The questions of whether Treg deficiencies underlie autoimmune pathology and whether or how Tr...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/BOR.0b013e32835d0ee4

    authors: Mijnheer G,Prakken BJ,van Wijk F

    更新日期:2013-03-01 00:00:00

  • Autoimmunity in scleroderma: the origin, pathogenetic role, and clinical significance of autoantibodies.

    abstract:PURPOSE OF REVIEW:Systemic sclerosis, or scleroderma, is a systemic autoimmune disease manifest by vascular damage and fibrosis within the skin and visceral organs. Whereas scleroderma is a heterogenous disorder in terms of disease symptoms and clinical course, scleroderma-specific autoantibody profiles associate stron...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-200311000-00016

    authors: Harris ML,Rosen A

    更新日期:2003-11-01 00:00:00

  • Biologic agents in the treatment of inflammatory rheumatic diseases.

    abstract::Due to our increasing knowledge of mechanisms underlying pathogenic events in autoimmune rheumatic diseases, biologic agents have been further explored and tested in open and controlled clinical trials. Based on the results of placebo-controlled trials, monoclonal antibodies to CD4+ T cells have been found ineffective...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-199505000-00006

    authors: Kalden JR,Manger B

    更新日期:1995-05-01 00:00:00

  • Work disability in rheumatic diseases.

    abstract:PURPOSE OF REVIEW:To review developments in the literature concerning work disability in the rheumatic diseases. RECENT FINDINGS:There have been three sets of studies to emerge in the last year. In the first, several studies analyze alternative research methods to document work disability. The second set uses qualitat...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/BOR.0b013e3280126b66

    authors: Yelin E

    更新日期:2007-03-01 00:00:00

  • Skin involvement in dermatomyositis.

    abstract:PURPOSE OF REVIEW:Dermatomyositis (DM) is a rare multisystem autoimmune disorder of adults and children that primarily affects skin and skeletal muscle. Classification systems of dermatomyositis, polymyositis, and the other idiopathic inflammatory myopathies focus primarily on features of muscle involvement. However, c...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-200311000-00006

    authors: Santmyire-Rosenberger B,Dugan EM

    更新日期:2003-11-01 00:00:00

  • Minimal disease activity in axial spondyloarthritis: the need of the hour and a proposal for development.

    abstract:PURPOSE OF REVIEW:Axial spondyloarthritis (axSpA) is a chronic inflammatory condition with articular and extra-articular manifestations. Remission, a state of absence of clinical and imaging signs of disease activity over time, is the goal of management. This review addresses the concept of minimal disease activity (MD...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/BOR.0000000000000387

    authors: Deodhar AA,Kumthekar A,Dubreuil M

    更新日期:2017-07-01 00:00:00

  • Management of systemic sclerosis: the first five years.

    abstract:PURPOSE OF REVIEW:This review provides a risk-stratified and evidence-based management for subsets of systemic sclerosis (SSc) patients in the first five years from disease onset. RECENT FINDINGS:Cardiopulmonary disease remains the primary cause of mortality in SSc patients. Morbidity and mortality in SSc-associated p...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/BOR.0000000000000711

    authors: Roofeh D,Khanna D

    更新日期:2020-05-01 00:00:00

  • Immunosuppressive drug therapy.

    abstract::Interstitial lung disease frequently complicates rheumatic disorders, especially polymyositis-dermatomyositis, rheumatoid arthritis, systemic sclerosis, and mixed connective tissue disease. In this article, we review the current data supporting the use of azathioprine, cyclophosphamide, chlorambucil, cyclosporine, and...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-199405000-00004

    authors: McCune WJ,Vallance DK,Lynch JP 3rd

    更新日期:1994-05-01 00:00:00

  • Rheumatic manifestations of neoplasia.

    abstract::Neoplasia in an important cause of rheumatic disease. The mechanisms are either direct infiltration of the bone and joint, or indirect infiltration with manifestations distant from the site of neoplastic involvement. Many of the reports reviewed in this article center on direct associations. In particular, there is a ...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-199102000-00020

    authors: Schwarzer AC,Schrieber L

    更新日期:1991-02-01 00:00:00

  • Infections and systemic vasculitis.

    abstract::Bacterial infections can clinically mimic a primary vasculitic syndrome and can directly cause a vasculitis that may respond to prompt recognition and treatment of the infection. Increasing direct and indirect evidence is establishing links between certain infections and vasculopathies, including aortitis, atheroscler...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-199801000-00008

    authors: Mandell BF,Calabrese LH

    更新日期:1998-01-01 00:00:00

  • AGEing and osteoarthritis: a different perspective.

    abstract:PURPOSE OF REVIEW:Across the world, osteoarthritis is the most commonly occurring musculoskeletal disease of the elderly, affecting more than 25% of the population older than 60 years of age. By far the single greatest risk factor for the development of osteoarthritis is age, but a mechanism to explain this relation ha...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-200309000-00016

    authors: Verzijl N,Bank RA,TeKoppele JM,DeGroot J

    更新日期:2003-09-01 00:00:00

  • Eosinophilia-myalgia syndrome, toxic-oil syndrome, and diffuse fasciitis with eosinophilia.

    abstract::The eosinophilia-myalgia syndrome, which is associated with the ingestion of L-tryptophan that contained products, occurred as an epidemic in the United States in 1989. Eosinophilia-myalgia syndrome is similar in many ways to the toxic-oil syndrome, which occurred in Spain in 1981, and to diffuse fasciitis with eosino...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:

    authors: Silver RM

    更新日期:1992-12-01 00:00:00

  • Eosinophilic myopathic syndromes.

    abstract::Eosinophilic infiltration into skeletal muscle, although rare, has been described in a diverse group of conditions. It most commonly occurs in parasitic infection as focal eosinophilic myositis but can be a feature of systemic hypereosinophilic conditions such as eosinophilia-myalgia syndrome and idiopathic hypereosin...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-199811000-00002

    authors: Pickering MC,Walport MJ

    更新日期:1998-11-01 00:00:00

  • Bone cytokines.

    abstract::Cytokines and growth factors are important in bone tissue as mediators of cell-to-cell and matrix-to-cell communication. Cytokines also locally mediate the effects of several hormones on bone cells. Indeed, calciotropic hormones modulate the bone-cell production rate of these factors and, conversely, can change the nu...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-199305030-00012

    authors: de Vernejoul MC,Cohen-Solal M,Orcel P

    更新日期:1993-05-01 00:00:00

  • Management of Behçet's syndrome.

    abstract:PURPOSE OF REVIEW:Current trends in the management of Behçet's syndrome will be reviewed in this article. RECENT FINDINGS:Biologic agents have gained increasing importance over the years in the management of Behçet's syndrome. Long-term results of observational studies have shown that anti-tumor necrosis factor agents...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/BOR.0000000000000231

    authors: Ozguler Y,Hatemi G

    更新日期:2016-01-01 00:00:00

  • Diagnosis, management and prevention of scleroderma renal disease.

    abstract:PURPOSE OF REVIEW:Renal complications are important in scleroderma (systemic sclerosis) and include scleroderma renal crisis. This is a medical emergency that requires careful management. Recent cohort studies have highlighted key aspects of management and outcome and these are reviewed. RECENT FINDINGS:Two recent art...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/BOR.0b013e3283108df7

    authors: Penn H,Denton CP

    更新日期:2008-11-01 00:00:00

  • Antiphospholipid antibodies in systemic lupus erythematosus and Sjögren's syndrome.

    abstract::The spectrum of clinical descriptions and clinicopathologic studies on patients with primary and secondary forms of antiphospholipid antibody syndrome continues to widen. Some differences exist for patients with lupus compared with those with Sjogren's syndrome. Some new thoughts regarding pathogenetic mechanisms and ...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-199305050-00007

    authors: McCarty-Farid GA

    更新日期:1993-09-01 00:00:00

  • Current concepts in the prevention, detection, and treatment of deep vein thrombosis in total hip and knee replacement.

    abstract::In hip replacement, prophylaxis of thromboembolism with warfarin to 1.5 times control with respect to prothrombin time remains efficacious. Further reduction of the dosage has not met with success. Confirmatory studies on the usefulness of adjusted-dose heparin and low molecular weight heparin continue. Promising new ...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/00002281-199204000-00013

    authors: Yen D

    更新日期:1992-04-01 00:00:00

  • Genetic determinants of bone mass.

    abstract:PURPOSE OF REVIEW:This review examines recent advances in the analysis of genetic determinants of bone mass. It addresses both human and animal linkage studies as well as genetic manipulations in animals, inbred mouse models, and candidate gene analyses. RECENT FINDINGS:Recent studies have implicated novel regulatory ...

    journal_title:Current opinion in rheumatology

    pub_type: 杂志文章,评审

    doi:10.1097/01.moo.0000127828.34643.b4

    authors: Baldock PA,Eisman JA

    更新日期:2004-07-01 00:00:00