Pediatric Metabolic Bone Clinic

Advanced treatments for pediatric metabolic bone disease

Our team has deep experience treating various types of metabolic bone disease using the latest infusion and injection therapies not widely available elsewhere.

Therapies include:

Vosoritide injections

Vosoritide is the first treatment approved by FDA for children with achondroplasia to improve final height. The drug allows bones and growth plates to continue to grow. Children with achondroplasia receive vosoritide injections at home. Our team shows you how to give this daily injection to your child. We manage achondroplasia with other experts to ensure appropriate screening and follow up.

Asfotase alfa injections

Asfotase alfa is the first and only enzyme replacement therapy for children with hypophosphatasia (HPP). Only a few centers have the specialists and expertise to treat this rare inherited bone disease.

Children with HPP receive asfotase alfa injections at home three times a week. Our experts help you feel confident giving your child these injections. Because this is a lifetime treatment, we work with older children and teens to help them learn to administer the shot themselves. We provide ongoing follow-up care at our clinic.

Zoledronic acid infusions

Children with various bone diseases benefit from outpatient infusions of zoledronic acid. We also offer this treatment to children who have osteogenesis imperfecta, pediatric osteoporosis and chronic recurrent multifocal osteomyelitis (CRMO).

Children with CRMO, a type of autoinflammatory syndrome, receive care at our Pediatric Rheumatology Clinic. Our bone disease experts can help when CRMO symptoms don’t improve with traditional treatments.

The use of zoledronic acid for pediatric osteoporosis and CRMO is exploratory. This means the FDA hasn’t yet approved the drug for these pediatric conditions. Not all medical centers offer this treatment. However, children who receive this therapy at our clinic are experiencing significant improvements.

Our team offers this treatment to select pediatric patients when the drug’s benefits outweigh the potential risks. Your child receives infusions every six months at our outpatient infusion center. We carefully monitor your child’s health at our clinic.

Burosomab injections

Children with X-linked hypophosphatemic rickets (XLH) have low phosphorous (phosphate) levels. Phosphorous works with calcium to build strong bones and teeth. Early signs of XLH include bowed knees or knock knees. We offer burosomab, the only FDA-approved XLH treatment. This medication increases phosphorous levels, heals leg abnormalities and fosters your child’s growth. Your child receives an injection every two weeks at home.

Specialized care for Duchenne muscular dystrophy

Our Metabolic Bone Clinic is unique in providing advanced care for children with Duchenne muscular dystrophy (DMD) who have low bone density. Our bone specialists and DMD experts work together to help maximize bone health and manage endocrine complications.

Our Duchenne Muscular Dystrophy (DMD) Program is the only Parent Project Muscular Dystrophy (PPMD) Certified Duchenne Care Center Program in Texas. We offer the highest-level care for children with DMD.

Team approach to care

Our clinic’s multidisciplinary approach means we partner with other specialists to provide your child with coordinated, comprehensive care. Depending on your child’s unique needs, they may also see specialists from these programs or clinics:

• Clinical Nutrition

• Orthopedics Program

• Nephrology Program

• Neurology Program

• Neurosurgery Program

• Physical Therapy

• Rheumatology Clinic

Bone density and vitamin D screenings

Some children may not get enough calcium or vitamin D in their diets to build healthy, strong bones. This can cause low bone density and an increased risk of fractures. Children who avoid certain foods due to lactose intolerance or food allergies are especially at risk.

Children’s Health is one of a few pediatric centers in the country offering onsite pediatric bone density tests using the latest dual-energy X-ray absorptiometry (DEXA) technology. This test measures mineral levels in specific bones in your child’s body. Our team knows how to make your child feel safe and comfortable during this quick and painless procedure.

If a scan indicates your child has low bone density, we offer treatments and nutritional counseling to help improve bone health.

How much calcium does your child need?

Your child’s bones and teeth store calcium to make them strong. Their muscles and nerves also need calcium to work properly. A growing child who doesn’t get enough calcium is at risk for nutritional rickets. These conditions make bones soft.

How much calcium your child needs depends on their age. Nutrition labels and supplements list calcium in milligrams (mg). The National Institutes of Health recommends these daily calcium amounts for children:

Life Stage

Recommended Amount

Birth to 6 months

200 mg

Infants 7-12 months

260 mg

Children 1-3 years

700 mg

Children 4-8 years

1,000 mg

Children 9-13 years

1,300 mg

Teens 14-18 years

1,300 mg

Your child needs 3 to 4 servings of low-fat dairy products every day to get about 1,000 mg of calcium.

Good sources of calcium include:

• Almonds

• Broccoli and kale

• Dairy products, including milk, yogurt and cheese

• Edamame (soybeans) and tofu

• Fortified soy, almond and oat milks

• Fortified cereal and juice

How much vitamin D does your child need?

Your child needs vitamin D to help their body absorb and retain calcium and phosphorus. These minerals are essential for strong bones.

Up to 15% of children ages 1 to 11 don’t get enough vitamin D. Teens are equally at risk. Growing children who don’t get enough vitamin D may develop soft bones or nutritional rickets.

The amount of vitamin D your child needs depends on their age. Nutrition labels and supplements list vitamin D in micrograms (mcg) and international units (IU). The National Institutes of Health recommends these vitamin D amounts for children:

Life Stage

Recommended Amount

Birth to 12 months

10 mcg (400 IU)

Children 1-13 years

15 mcg (600 IU)

Teens 14-18 years

15 mcg (600 IU)

Good sources of vitamin D include:

• Eggs

• Fortified milk, including dairy, soy, almond and oat milks

• Fortified cereals and juices

• Salmon and tuna

• Shiitake mushrooms

Research

2 key treatment advances for pediatric metabolic bone diseases

Resources

• Growth Visit Storybook - English

• Growth Visit Storybook - Spanish

Metabolic bone disease can cause your child to have severe bone pain, stunted growth, debilitating fatigue and multiple fractures. These symptoms and others can negatively affect your child’s ability to attend school, be active and enjoy their childhood. Our team offers cutting-edge treatments for common and rare metabolic bone diseases.

The Pediatric Metabolic Bone Clinic at Children’s Health℠ is part of our nationally recognized Pediatric Endocrinology Program. We are also one of a few clinics nationally providing comprehensive care for children with Duchenne muscular dystrophy (DMD) who have low bone density and other endocrine issues related to prolong steroid treatments.

Our pediatric bone disease experts partner with other Children’s Health specialists to provide comprehensive care for your child’s unique medical needs. We’re dedicated to helping your child feel better, grow and thrive.