Kay,

 

Your post inspired me to do a little research of my own.  I had known that glucocorticoid use was associated with bone loss, but didn't know that Lupron was, as well, until I read your note.  In fact, there are quite a number of abstracts on this subject on the Pub-Med website.  I searched using the keywords, "Lupron bone density."

 

The best article on this subject that I came across, and that seemed to be the most relevant to our children, is "Long-Term Outcome after Depot Gonadotropin-Releasing Hormone Agonist Treatment of Central Precocious Puberty: Final Height, Body Proportions, Body Composition, Bone Mineral Density, and Reproductive Function."  You can find it at http://jcem.endojournals.org/cgi/content/full/84/12/4583 .  As an added bonus, the full text is currently free of charge, online.

 

The authors of this article reported no negative effect on bone mineral density, but acknowledged that bone loss has been reported by other researchers, as a result of treatment.  (This article contains a lot of footnotes and references, so one can continue researching endlessly.)  I am still trying to absorb and understand all the information, but, from what I can gather, the reason why glucocorticoids and Lupron are both associated with bone loss is because they reduce the amount of estrogen in the system, which, especially for females, is very important for bone growth.  Your daughter's large number of bone breaks definitely sounds remarkable and, given that she has been on two different medications often associated with bone loss, it would seem that there has to be some sort of correlation (doesn't it?!) 

 

I'm sorry I don't have much personal experience with this issue, as my son has been receiving Lupron injections for only a little over a year now.  He is very athletic and physically active, but has never had any sort of fracture, though I believe that bone loss is more prevalent in females, anyway.  Though this may not be as big an issue for us, in the end, it is always good to know what we might possibly run into, down the road. 

 

I'd be interested in knowing how your daughter did on the Lupron, otherwise, if you are comfortable sharing the information.  How old was she when she started the shots, and what was her bone age, at the time?  What is her bone age now, at the chronological age of 12?  Also, what was her height, at the start of Lupron treatment, and what is it now? 

 

My son was 6 1/2 at diagnosis, with a bone age just under 13, so his major issue with the CAH is loss of stature.  He just turned 8, and, luckily, his bone age has only advanced about 6 months in about 20 months time.  I am still trying to fully understand all the different factors that come into play in trying to achieve maximum adult height, so any personal insight that you (or any others with children on Lupron) can give would be greatly appreciated.  Thanks!