Rehabilitation in a case of severe osteoporosis with prevalent fractures in a patient known with multiple sclerosis and prolonged glucocorticoid therapy

Introduction. Osteoporosis has a major influence on the quality of life because of its impact on bone strength. Osteoporosis and fractures are frequent in patients with multiple sclerosis, decreased mobility being an important risk factor in these patients. Objectives. This paper presents a case of severe osteoporosis in a patient with multiple sclerosis, to emphasize a correlation between this two pathologies. Material and Methods. We present the case of a female Caucasian patient, aged 65 years, known with progressive multiple sclerosis, on long-term use of glucocorticoids, and severe osteoporosis, who is investigated for mechanical pain and functional deficiency in the lumbar spine and the right hip, motor deficit, predominantly on right limbs and walking disorders. The patient was diagnosed with severe osteoporosis treated with raloxifene and bisphosphonates, with multiple vertebral fractures and vitamin D deficiency. During hospitalization the patient followed myorelaxant therapy and an individualized rehabilitation program. Results and discussion. During follow-up, there was a significant increase followed by a recent decrease in bone mass density in the lumbar spine and hip. The patient was recommended a loading dose of cholecalciferol for three months and initiation of teriparatide therapy after restoring 25-hydroxy vitamin D levels. Conclusion. In patients with multiple sclerosis,screening and early management of osteoporosis and osteopenia are essential. Keywords: multiple sclerosis, glucocorticoid therapy, osteoporosis,

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VITAMIN D LEVELS, VITAMIN D INTAKE AND SUNLIGHT EXPOSURE IN PEDIATRIC MULTIPLE SCLEROSIS

Neuropediatrics ◽

10.1055/s-2006-945647 ◽

2006 ◽

Vol 37 (S 1) ◽

Author(s):

R Hung ◽

R Vieth ◽

R Goldman ◽

E Sochett ◽

B Banwell

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Sunlight Exposure ◽

Pediatric Multiple Sclerosis ◽

Vitamin D Intake ◽

Vitamin D Levels

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Reduction in circulating vitamin D binding protein in patients with multiple sclerosis

BMC Neurology ◽

10.1186/s12883-021-02200-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhila Maghbooli ◽

Abolfazl Omidifar ◽

Tarlan Varzandi ◽

Tayebeh Salehnezhad ◽

Mohammad Ali Sahraian

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Binding Protein ◽

Serum Levels ◽

Causative Role ◽

Vitamin D Binding Protein ◽

Control Groups ◽

Current Case ◽

Vitamin D Levels ◽

And Control

Abstract Background In this study, we aimed to determine the risk association between vitamin D binding protein (VDBP) polymorphism in patients with multiple sclerosis (MS) in a MS biobank and the difference in VDBP serum levels in MS patients who were recently diagnosed. Method The current case-control study was performed on 296 MS patients and 313 controls. Thereafter, two common missense VDBP polymorphisms, named rs7041and rs4588, were evaluated in all the participants. Serum levels of vitamin D and vitamin D binding protein were assessed in 77 MS patients who were diagnosed since one year ago and in 67 healthy people who were matched in terms of age and sex. Result The frequency distributions of VDBP genotypes and alleles of SNP rs7041 and rs4588 were observed to be similar in both the MS and control groups (p > 0.05). The VDBP haplotypes, as Gc2/Gc2, Gc1/Gc1, and Gc1/Gc2, were found to be similar in the MS and control groups (p > 0.05). In subgroup analysis, circulating VDBP was lower in MS patients (Ln-VDBP (μgr/ml): 3.64 ± 0.91 vs. 5.31 ± 0.77, p = 0.0001) even after adjusting for vitamin D levels, body mass index, and taking vitamin D supplement. There was no significant association between VDBP haplotypes and vitamin D levels in the two groups. Conclusion The present study suggested an association between lower levels of circulating VDBP and multiple sclerosis in newly diagnosed patients. However, the VDBP causative role in the development of MS is still unclear, so it needs more studies.

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Comparison of Antioxidant Status and Vitamin D Levels between Multiple Sclerosis Patients and Healthy Matched Subjects

Multiple Sclerosis International ◽

10.1155/2014/539854 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Ehsan Hejazi ◽

Reza Amani ◽

Naser SharafodinZadeh ◽

Bahman Cheraghian

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Dietary Intake ◽

Antioxidant Status ◽

Sun Exposure ◽

Total Antioxidant Status ◽

Serum Levels ◽

Study Groups ◽

Vitamin D Levels ◽

Multiple Sclerosis Patients

Objective. The aim of the present study was to compare the serum levels of total antioxidant status (TAS) and 25(OH) D3 and dietary intake of multiple sclerosis (MS) patients with those of normal subjects.Method. Thirty-seven MS patients (31 women) and the same number of healthy matched controls were compared for their serum levels and dietary intake of 25(OH) D3 and TAS. Sun exposure and the intake of antioxidants and vitamin D rich foods were estimated through face-to-face interview and food frequency questionnaire.Results. Dietary intake of antioxidants and vitamin D rich foods, vitamin C, vitamin A, and folate was not significantly different between the two groups. There were also no significant differences in the mean levels of 25(OH) D3 and TAS between the study groups. Both groups had low serum levels of 25(OH) D3 and total antioxidants.Conclusion. No significant differences were detected in serum levels and dietary intake of vitamin D and antioxidants between MS patients and healthy controls. All subjects had low antioxidant status and vitamin D levels.

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Vitamin D levels in people with multiple sclerosis and community controls in Tasmania, Australia

Journal of Neurology ◽

10.1007/s00415-006-0315-8 ◽

2007 ◽

Vol 254 (5) ◽

pp. 581-590 ◽

Cited By ~ 214

Author(s):

I. A. F. Mei ◽

A.-L. Ponsonby ◽

T. Dwyer ◽

L. Blizzard ◽

B. V. Taylor ◽

...

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Vitamin D Levels ◽

Community Controls

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No correlation was observed between vitamin D levels and disability of patients with multiple sclerosis between latitudes 18° and 30° South

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20160173 ◽

2017 ◽

Vol 75 (1) ◽

pp. 3-8 ◽

Cited By ~ 4

Author(s):

Yara Dadalti Fragoso ◽

Tarso Adoni ◽

Soniza Vieira Alves-Leon ◽

Samira L. Apostolos-Pereira ◽

Walter Oleschko Arruda ◽

...

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Large Population ◽

Serum Vitamin ◽

Serum Levels ◽

Serum Vitamin D ◽

Control Subjects ◽

Vitamin D Levels ◽

The Mean ◽

25 Oh Vitamin D

ABSTRACT Objective: Vitamin D has taken center stage in research and treatment of multiple sclerosis (MS). The objective of the present study was to assess the serum vitamin D levels of a large population of patients with MS and controls living in a restricted tropical area. Methods: Data from 535 patients with MS and 350 control subjects were obtained from 14 cities around the Tropic of Capricorn. Results: The mean serum 25-OH vitamin D level was 26.07 ± 10.27 ng/mL for the control subjects, and 28.03 ± 12.19 ng/mL for patients with MS. No correlation was observed between vitamin D levels and the disability of patients over the disease duration. Conclusion: At least for the region around the Tropic of Capricorn, serum levels of vitamin D typically are within the range of 20 to 30 ng/mL for controls and patients with MS.

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Association of cholesterol 7α-hydroxylase (CYP7A1) promoter polymorphism (rs3808607) and cholesterol 24S-hydroxylase (CYP46A1) intron 2 polymorphism (rs754203) with serum lipids, vitamin D levels, and multiple sclerosis risk in the Turkish population

Neurological Sciences ◽

10.1007/s10072-021-05597-1 ◽

2021 ◽

Author(s):

Eda Sezer ◽

Birsen Can Demirdöğen ◽

Şeref Demirkaya ◽

Giray Bulut ◽

Merve Akkulak ◽

...

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Serum Lipids ◽

Turkish Population ◽

Promoter Polymorphism ◽

Multiple Sclerosis Risk ◽

Vitamin D Levels ◽

Intron 2

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Polymorphisms in vitamin D metabolism related genes and risk of multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458509355069 ◽

2009 ◽

Vol 16 (2) ◽

pp. 133-138 ◽

Cited By ~ 88

Author(s):

K. Claire Simon ◽

Kassandra L Munger ◽

Xing Yang ◽

Alberto Ascherio

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Conditional Logistic Regression ◽

Dietary Vitamin ◽

Environment Interaction ◽

Nucleotide Polymorphisms ◽

Vitamin D Metabolism ◽

Logistic Regression Models ◽

Gene Environment ◽

Vitamin D Levels

The extent to which potential genetic determinants of vitamin D levels may be related to multiple sclerosis (MS) risk has not been thoroughly explored. The objective of this study was to determine whether polymorphisms in VDR, CYP27B1, CYP24A1, CYP2R1 and DBP are associated with the risk of MS and whether these variants may modify associations between environmental or dietary vitamin D on MS risk. A nested case-control study was conducted in two, large cohorts of US nurses, including 214 MS cases and 428 age-matched controls. Conditional logistic regression models were used to calculate relative risks (RR) and 95% confidence intervals (CIs) and to assess the significance of gene—environment interactions. No associations were observed for any of the single-nucleotide polymorphisms (SNPs) in VDR, CYP27B1, CYP24A1, CYP2R1 or DBP (p > 0.05 for all). The authors did observe an interaction (p = 0.04) between dietary intake of vitamin D and the vitamin D receptor FokI polymorphism on MS risk. The protective effect of increasing vitamin D was evident only in individuals with the ‘ff ’ genotype (RR = 0.2, 95% CI: 0.06, 0.78; p = 0.02 for 400 IU/day increase). It was concluded that this does not support a role for the selected SNPs involved in vitamin D metabolism in the etiology of MS. The finding of a marginally significant gene—environment interaction requires replication in larger datasets, but suggests future genetic studies may benefit from considering relevant environmental context.

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