Bone Fractures in Children With Cholestatic Liver Disease May Mimic Those Seen in Child Abuse.
Autor: Goldner, Dana; Vittorio, Jennifer; Barrios, Dulce M.; McGuire, Jillian; Brodlie, Susan; Brown, Jocelyn; Lobritto, Steven; Martinez, Mercedes
Publication year: 2021
Pediatric emergency care
issn:1535-1815 0749-5161
doi: 10.1097/PEC.0000000000001740
Abstract:
Certain fractures in children are highly specific for child abuse. Metabolic bone disease frequently develops in patients with cholestatic liver disease (CLD); this can result in weakened bones and a predisposition to pathologic fractures. Fractures that occur in patients with rickets and osteopenia may mimic a bone response to inflicted injury, which in children raise the concern of child abuse. Here we report a series of 15 patients with CLD who developed pathologic fractures in the setting of metabolic bone disease. During initial evaluation, the caretakers of 5 of these 15 patients were reported to child protective services and investigated for child abuse. Pediatricians should be aware that children with CLD have an increased incidence of pathologic fractures, even after the cholestasis has resolved.
Language: eng
Rights: Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Pmid: 30672906
Tags: Humans; Child; Infant; *Child Abuse/diagnosis; *Cholestasis; *Fractures, Bone/diagnosis; *Liver Diseases/diagnosis; *Rickets
Link: https://pubmed.ncbi.nlm.nih.gov/30672906/
