How Chronic Glucocorticoid Use Can Affect Your Child’s Bones

What are glucocorticoids?

Glucocorticoids (also called corticosteroids) are a type of steroid medication that lessen inflammation in the body. Glucocorticoids are a widely used to treat severe asthma, arthritis, Crohn’s disease, ulcerative colitis, tendinitis, eczema and many other disorders.

What are the side effects of overusing glucocorticoids?

One significant side effect of chronic glucocorticoid use is glucocorticoid-induced osteoporosis, which results in a condition of significant decreased in bone mineral density (which reflects bone strength), with an increased in the risk for fracture.

Other side effects can include:

• Weight gain
• Poor growth and short stature
• High blood pressure
• Weakened immune system
• Thin skin (if topical products are used, or if products are applied to the skin)
• Fungal infections (if inhalers are used)

What are the clinical features of glucocorticoid-induced osteoporosis?

These include:

• Bone fractures (particularly of the spine), which may cause:
• Back pain
• Decrease in height
• Change in posture

How do doctors treat chronic glucocorticoid-induced osteoporosis?

The first step is for your child’s care team to lessen your child’s steroid use if this is possible. This prevents your child from losing further bone mineral density and lowers their risk of a fracture. Because the extent of loss in bone mineral density can differ in different people, next steps often depend on how much damage has occurred.

The care team may also prescribe medications such as bisphosphonates to improve bone density and strength.

Rev. 3/2022. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.