Khodanich N. Diagnosis and correction features of osteoporotic disorders in articular form of Juvenile Rheumatoid Arthritis

The dissertation is devoted to one of the important tasks of Pediatrics - improving of the quality of diagnosis and effective correction of the osteoporotic violations of juvenile rheumatoid arthritis based on the results of studies of biochemical processes of bone remodeling, calcium metabolism, balance of osteotropic macro- and micronutrients, as well as the ultrasound bone densitometry results. The study is based on the results of investigation of 81 children with AF JRA and 25 - with reactive arthritis at the age of 6 to 16 years. Oligoarticular form was diagnosed in 46,9%, II degree of activity (87,6%), slow progressively over (77,8%), II X-ray stage (60,5%). It is shown that at the onset of AF JRA hypercompensation processes of bone formation with subsequent activation of bone resorption were observed, and in ReA stable compensation of bone tissue remodeling dominants. According to a study the differential-diagnostic algorithm AF JRA and ReA is presented. The investigation of the rank-degree deviation from the normal indicates greater information of bone tissue disorders remodeling than the impaired calcium-phosphorus metabolism and content of microelements in osteotropic hair. The usage of Calcium-D3 Nycomed has a strong positive impact on the calcium metabolism, normalization of the balance of important osteotropic macro-and micronutrients with a consistent recovery of the morphofunctional state of bone tissue, eliminating or significantly decreasing of frequency osteoporosis violations. The usage of drug over 1 month in one third of patients exacerbates of osteotropic deficiency, elements (Mn, Zn, I, Se) including calcium antagonists as a consequence further correction is not feasible. Key words: juvenile rheumatoid arthritis, calcium metabolism, micronutrients osteotropic correction, "Calcium-D3 Nycomed".