Steroids and the risk of osteoporosis
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I came across an interesting case report in a journal published in association with patient safety charity AvMA (Action against Medical Accidents: www.avma.org.uk), involving a young woman who had been prescribed steroid eye drops for uveitis, an eye condition in which the uvea, the pigmented layer within the eye, become inflamed.
Unfortunately, she responded very sensitively to the steroids and, despite high pressures within her eyes being detected she continued to be prescribed them over a number of months. As a result of the unchecked excessive pressures within her eyes, she developed glaucoma, cataracts and visual loss. In addition, the young woman also went on to develop osteoporosis and suffered a number of 'fragility fractures' due to the of steroids having been prescribed without the recommended 'bone protection' medication.
Steroids are used to treat a number of acute and chronic clinical conditions from chronic obstructive pulmonary disease and asthma, to rheumatological conditions such as arthritis and temporal arteritis. Generally, they are very effective at reducing inflammation and managing disease, however consideration does also need to be given to the long list of potential side effects associated with their use, and how to limit the effect of these as far as is reasonably possible. In particular, high doses and long term use of steroids are linked to the risk of a reduction in bone density and the development of osteoporosis, which can be a devastating condition for all age-groups. Consideration should be given to prescribing patients taking long term steroids with some form of 'bone protection' medication including calcium and vitamin D, in order to try to prevent this loss of bone density thus lowering the risk of osteoporotic fractures.
There are National guidelines recommended to GPs regarding the assessment of individuals in order to determine their risk of developing steroid-induced osteoporosis. If you are concerned about your risk you should speak to your GP or practice nurse for advice. As well as the use of steroids, the risk of osteoporosis can be increased further still depending on your age, sex, lifestyle and co-morbidities. You can read more on this useful information sheet: http://patient.info/health/preventing-steroid-induced-osteoporosis
At BL Claims, we have both the medical and legal knowledge and experience required to advise on any concerns you may have that the management of steroid treatment has fallen below an acceptable standard, we would be happy to discuss with you so please do contact us.
(Clinical Risk - 21, 6 Nov 2015)
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