Idiopathic osteoporosis is a rare condition that affects both sexes, women during menacme and men before 65 years. The diagnosis can only be considered after all known causes of osteoporosis are discarded. The clinical presentation is heterogeneous, ranging from densitometric finding in a patient with few symptoms to multiple fragility fractures, mainly vertebral. Bone turnover is usually in the low-normal range, but bone resorption always exceeds formation, resulting in net bone loss. The osteoblastic dysfunction, described in almost all papers, has been related to low insulin growth factor-1 (IGF-1) concentrations in blood and bone matrix. Genetic and hormonal factors seem to be involved. Antiresorptive drugs, such as bisphosphonates, are useful in reducing fracture rate. Anabolic drugs, such as growth hormone, IGF-1 and more recently teriparatide (recombinant PTH) are more promising, as they actually increase bone mass and improve bone quality. The purpose of this article is to review pathophysiologic aspects of idiopathic osteoporosis, diagnostic routine and therapeutic alternatives.
Idiopathic osteoporosis; GH; treatment