OSTEOPOROSIS IN MEN UNDER 65 YEARS OLD - REPORT OF 9 CASES

Background: Osteoporosis in young or middle age men is unusual and req uires an extensive diagnostic work-up. Aim. To report a retrospective review, of nine men with osteoporosis. Patients and methods: The chart s of nine men aged 27 to 61 years old (mean 39) that presented with a primary diagnosis of osteoporosis, were reviewed. Results: Subjects we re subjected to a diagnostic work up five years after the onset of sym ptoms. Their body mass index ranged from 21.7 to 26.3 kg/m(2), all had vertebral fractures (crush fractures in 8 and a biconcave deformity i n one) between T4 and L4 and all had normal serum calcium phosphate, a lkaline phosphatase and creatinine. Four patients had a history of nep hrolithiasis and three had hypercalciuria. Bone density measured in se ven patients with a dual photon densitometer, showed a mean Z score of -2.0 in the spine and of-2.2 in the femoral neck. The final diagnoses of these patients were Gushing's disease in two, malabsorption syndro me in one, use of phenobarbital and hydantoin in one, overt renal hype rcalciuria with low calcium intake in one and alcoholic liver disease in one. In three patients, osteoporosis was considered idiopathic. Of these, two had moderate absorptive hypercalciuria as a presumable risk factor. Conclusions: Six of the nine studied male patients with osteo porosis had an underlying cause and in three, this condition was consi dered idiopathic.