Use of zoledronic acid in thalassemia-induced osteoporosis: two case reports and review of the literature/Talasemi osteoporozunda zoledronik asit kullanimi: iki olgu sunumu ve literaturun gozden gecirilmesi

The life span of thalassemia major patients has been extended with early diagnosis and treatment modalities. This condition has resulted in an increase in osteoporosis-related problems. Even with optimal transfusions, the bone marrow of these patients remains hyperactive. For this reason, despite blood transfusion, iron chelation, and sex hormone replacement therapy, generalized osteoporosis and osteopenia are still frequent in thalassemia patients. In thalassemia-induced osteoporosis, bone resorption increases. This condition makes biphosphonates, which are potent inhibitors of osteoclast function, the drug of choice. ln this article, two sisters with thalassemia major and secondary osteoporosis are discussed and the results of treatment with intermittent zoledronic acid (iv. 4 mg) for 6 years are presented. We also performed a review of the literature on the etiopathogenesis of thalasemia-induced osteoporosis and the treatment modalities. Key Words: Thalassemia, osteoporosis, zoledronic acid Talasemi major hastalarinda, erken tani ve uygulanan tedaviler ile yasam suresinin uzamasiyla birlikte, osteoporozla iliskili sorunlar belirgin sekilde artmistir. Bu hastalarda optimal transfuzyonlarla bile kemik iligi hiperaktif kalmaktadir. Bu nedenle transfuzyonlar, demir selasyonu ve seks hormonlariyla optimal tedaviye ragmen jeneralize osteoporoz ve osteopeni talasemide sik gorulmektedir. Talasemiye bagli osteoporozda kemik rezorbsiyonunun artmis olmasi osteoklast fonksiyonunun potent inhibitorleri olan bifosfonatlarin kullanimini gundeme getirmistir. Bu makalede talasemi major ve sekonder osteoporoz tanilariyla takip edilen iki kizkardes tartisilmakta ve 6 yil sure ile uygulanan 4 mg aralikli zoledronik asit tedavisinin sonuclari sunulmaktadir. Talasemide gelisen osteoporozun etyopatogenezi ve uygulanan tedavi yaklasimlari gozden gecirilmektedir. Anahtar Kelimeler: Talasemi, osteoporoz, zoledronik asit