Bone Fractures in Children With Cholestatic Liver Disease May Mimic Those Seen in Child Abuse
ABSTRACTCertain 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 os...
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Published in: | Pediatric emergency care Vol. 37; no. 10; pp. e636 - e639 |
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Main Authors: | , , , , , , , |
Format: | Journal Article |
Language: | English |
Published: |
United States
Lippincott Williams & Wilkins
01-10-2021
Copyright Wolters Kluwer Health, Inc. All rights reserved |
Online Access: | Get full text |
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Summary: | ABSTRACTCertain 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. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0749-5161 1535-1815 |
DOI: | 10.1097/PEC.0000000000001740 |