Severe osteopenia with recurrent fractures after bone marrow transplant for Wiskott-Aldrich syndrome: A case report

Wiskott-Aldrich syndrome (WAS) is a rare inherited disorder characterised b y thrombocytopenia, eczema, and immunodeficiency. Bone marrow transplantati on (BMT) is a well-established modality of treatment now routinely used and often curative. We report the case of a boy who developed osteopenia and s ustained multiple long-bone fractures over a 5-year period after bone marro w transplant for WAS. The femora and tibiae of both lower limbs were involv ed with a clinical presentation similar to osteogenesis imperfecta. After c ommencing calcitriol treatment at the age of 8 years, the patient has not s ustained any further fractures, lie is now 11 years old. Although short-ter m changes in bone metabolism after BMT have been documented, the occurrence of repeated fractures associated with osteopenia has not been previously r eported.