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Craig B Langman (Chicago, USA)

Rare bone diseases in children

Friday 12 May 2006
13.00-14.00

Disorders of mineral metabolism in children have an accompanying expression in bone. This may manifest as rickets, hyperparathyroid bone disease, adynamic bone disease, or osteoporosis. We will develop a pathophysiologic schema for abnormalities of serum calcium, phosphorus, and vitamin D metabolism, which lead uniquely to one of these bone disturbances.

Hypercalcemia will be discussed as a consequence of mutations in the genes for the extracellular Ca-sensing receptor (eCaSR), in the PTH/PTHrp-Receptor-1, or as a consequence of elevated levels of 1,25-dihydroxyvitamin D. Normocalcemia with bone disease will include a discussion of idiopathic hypercalciuria and posited mutations in the VDR, CLCN5, or other genes. Hypocalcemia will involve a discussion of altered vitamin D metabolism from 1-alpha-hydroxylase mutations, acquired resistance from VDR mutations, disordered VDR-RXR heterodimerization, or eCaSR mutations.

The role of FGF-23 in disorders of phosphorus metabolism in children will be highlighted, along with the resultant diversity of bone diseases.

This seminar will involve audience participation for the construction of normal and abnormal pathways of metabolism, in addition to having the audience present their experience in diagnostic and therapeutic approaches to the disease entities discussed.

Key educational goals

  • Understand the link between disorders of serum minerals and bone disease in children.
  • Understand the link between disorders of vitamin D and bone disease in children.
  • Understand the pathophysiology of bone disease as a function of genetic mutations.
  • Understand the diagnostic and therapeutic approaches to metabolic bone diseases in children.

 

Target audience

  • Physicians who care for, or provide consultation to, patients with bone diseases in the childhood years.
  • Scientists interested in bone diseases in children.

 

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