Childhood and adolescence are critical periods of bone growth, and by the end of adolescence, a young person should have built up over 90 percent of his or her bone mass.

Lupus itself and many of the medications used to treat it, including corticosteroids, can cause loss of bone minerals such as calcium. When these minerals aren’t at the correct level, bones may not be able to grow normally and may lack normal bone strength. This means that children and teens with lupus are at an increased risk for delayed skeletal growth, short stature and fractures later in life.

For children and teens who are on steroids, you should discuss with the provider their recommendation for bone density testing by dual X-ray absorptiometry (DEXA). The measurement can be monitored over time to see if any therapy is needed.

Your child’s doctors should be able to assess risks of low bone mass such as osteoporosis (thinning or loss of bone tissue over time). Other risks associated with low bone mass include lupus nephritis (inflammation in the kidneys), low levels of vitamin D and reduced ability to be physically active.

Treatments doctors can offer children and teens with these risks are vitamin D and calcium supplements and weight-bearing and aerobic exercise as appropriate.