PRACA PRZEGLĄDOWA
Znaczenie układu OPG/RANKL/RANK w destrukcji kości w przebiegu reumatoidalnego zapalenia stawów
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Data publikacji online: 10-06-2009
Reumatologia 2009;47(2):67-74
SŁOWA KLUCZOWE
STRESZCZENIE
W przewlekłych chorobach zapalnych narządu ruchu często obserwuje się zmniejszenie gęstości mineralnej kości. U ok. 50% chorych z chorobami reumatycznymi rozwija się „osteoporoza śródzapalna” o nasileniu proporcjonalnym do stopnia aktywności choroby i wieku chorych. We wczesnym reumatoidalnym zapaleniu stawów (RZS) jej przyczyną jest aktywacja osteoklastów, a jednym z objawów – okołostawowy zanik kostny spowodowany miejscowym odczynem zapalnym. Osteoporoza w RZS może być także powodowana przez unieruchomienie i leczenie glikokortykosteroidami, a u kobiet w okresie menopauzy zaburzeniami hormonalnymi. Ryzyko złamań niskoenergetycznych u chorych na RZS jest zwiększone. Pojawia się pytanie, czy główną przyczyną osteoporozy w RZS jest zapalenie czy działanie glikokortykosteroidów oraz, czy doprowadza to tylko do ubytku gęstości mineralnej kości czy także do zwiększonej liczby złamań u chorych.
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