Effect of High-Dose Glucocorticosteroid Treatment for Infantile Spasms on Quantitative Bone Parameters Later in Life

Abstract

This study evaluated possible long-term effects of prolonged high-dose glucocorticosteroid administration in infancy. Thirty patients (16 male, 14 female; age 4.8–33 years) who had completed treatment with adrenocorticotropic hormone (ACTH) followed by glucocorticoids for infantile spasms at a tertiary pediatric hospital at least 2 years previously were invited to undergo quantitative bone ultrasound. The mean speed of sound Z score was -1.085 ± 1.079 for the radius and -0.22 ± 1.19 for the tibia on the nondominant side ( P = .0022). The difference from the reference mean (0) was statistically significant for the radius ( P < .001). There were no significant differences in radial or tibial mean speed of sound Z scores by age (prepubertal versus pubertal/postpubertal). In conclusion, a high percentage of patients treated with glucocorticoids for infantile spasms have a low radial speed of sound Z score later in life. Long-term follow-up can help to prevent and treat impairments in bone density, especially in non–weight-bearing organs.