José Pedro Patrício, Patrícia Oliveira, Maria Teresa Faria, Maria Berta Pérez, Jorge Pereira

Serviço de Medicina Nuclear, Hospital de São João, Porto

Resumo

Os corticoesteróides são fármacos utilizados no tratamento de diversas patologias, pelas suas propriedades anti-inflamatórias e imunossupressoras. No entanto, secundariamente, produzem alterações importantes na fisiologia normal da remodelação óssea que predispõem à osteoporose. Os impactos de morbilidade e mortalidade da osteoporose são conhecidos. Os corticoesteróides são a causa mais comum de osteoporose secundária; contudo, vários estudos documentam uma má aplicação das recomendações internacionais na prevenção da osteoporose induzida por corticoesteróides. Este trabalho tem como objectivos rever a fisiopatologia da osteoporose induzida por corticoesteróides, esclarecer o papel da absorciometria radiológica de dupla energia no diagnóstico e monitorização terapêutica e referir os aspectos elementares da prevenção e tratamento destes doentes.

Palavras-chave: osteoporose; corticoesteróides; densitometria.

Corticosteroids Induced Osteoporosis

Corticosteroids are widely used in the therapeutic of several pathologies because of their anti-inflammatory and immunossupresive effects. However, they interfere in normal physiology and bone remodeling, conducing to osteoporosis. The impacts of osteoporosis on morbidity and mortality are well known. Corticosteroids are the main cause of secondary osteoporosis; nevertheless, many studies document the incorrect use of international guidelines concerning the prevention of costicosteroid induced osteoporosis. The aim of this paper is to review the physiopathology of corticosteroid induced osteoporosis, to clarify the contribute of dual energy x-ray absorptiometry in the diagnosis and therapeutic monitoring, and to refer basic aspects of prevention and treatment of those patients.

Key-words: osteoporosis; corticosteroids; densitometry.

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Correspondência:

Dr. José Pedro Patrício

Serviço de Medicina Nuclear

Hospital de São João

Alameda Prof. Hernâni Monteiro 4200-319 Porto

e-mail: josepedropatricio@gmail.com