Effect of high-dose glucocorticosteroid treatment for infantile spasms on quantitative bone parameters later in life

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.