Secondary osteoporosis and related bone diseases

Bones are very sensitive to other diseases. Bone loss is seen with decreased mechanical forces (bedrest), weight loss for any reason, decreased hormone levels, acidosis, most catabolic stresses and any kind of inflammation. Often osteoporosis is a result of combinations of risk factors and chronic diseases. Some of the hereditary diseases should logically be classified as primary osteoporosis but are listed here just to remind readers that there are many kinds and causes of osteoporosis.

Here is a list of diseases to consider when a person suffers from a fragility fracture or has low bone density Z-scores. This is certainly not the complete list of causes of osteoporosis, but does include the most common ones:

Medications corticosteroids, dilantin and other anticonvulsants, gonadotropin releasing hormone agonists, loop diuretics, methotrexate, excess thyroid, heparin, depo-medroxyprogesterone acetate, anti-neoplastic agents, cyclosporin, proton-pump inhibitors, selective serotonin reuptake inhibitors, aromatase inhibitors
Hereditary skeletal/connective tissue diseases osteogenesis imperfecta, rickets, hypophosphatasia, Marfan's syndrome, pseudoglioma.
Endocrine and metabolic HYPOGONADISM, prolactinoma, hypopituitarism, hyperparathyroidism, hyperthyroidism, Cushing syndrome, acidosis, diabetes type I and type II, androgen insensitivity, Gaucher's disease, hemochromatosis
Gastro-intestinal Celiac sprue, malabsorption, malnutrition, inflammatory bowel disease, chronic hepatic disease
Rheumatologic diseases systemic lupus, ankylosing spondylitis, rheumatoid arthritis
Marrow diseases myeloma, mastocytosis, thalassemia, leukemia
Renal disease Chronic Kidney Disease, renal tubular acidosis, Hypercalciuria
Neurologic diseases spinal cord injury, stroke, Parkinson's disease, history of polio
Psychiatric diseases alcoholism, depression, anorexia nervosa
Pulmonary diseases chronic obstructive pulmonary disease, cystic fibrosis
Other organ transplantation, lactation, AIDS, transient regional osteoporosis, any disease that causes serious weight loss or prolonged bedrest
Fractures not caused by osteoporosissevere trauma, cancer metastasis to the bone, Paget's disease, tuberculosis (Pott's disease), avascular necrosis, fibrous dysplasia, osteomalacia, repetitive injury (March fractures)

Updated 12/11/08
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