{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T10:31:34Z","timestamp":1785148294376,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Glucocorticoid\u2010induced osteoporosis (GIOP) is a significant complication of prolonged glucocorticoid treatment in paediatric nephrotic syndrome, but the optimal treatment strategy remains unclear. We report the case of a 17\u2010year\u2010old boy with steroid\u2010resistant nephrotic syndrome due to focal segmental glomerulosclerosis who developed progressive bone fragility during high\u2010dose glucocorticoid treatment. Four months after initiation of glucocorticoids, his lumbar bone mineral density (BMD) decreased 9.2%, serum alkaline phosphatase (S\u2010ALP) decreased 22% and serum tartrate\u2010resistant acid phosphatase\u20105b (S\u2010TRACP\u20105b) increased 47% compared with baseline, indicating compromised bone strength. Oral alendronate (35\u2009mg\/week) was initiated to prevent progression of GIOP. One month after antiresorptive treatment, S\u2010TRACP\u20105b decreased 87% from the level measured at 4\u2009months. BMD and S\u2010ALP initially continued to decline slightly until 7\u2009months but subsequently demonstrated sustained recovery. S\u2010TRACP\u20105b levels were lower than baseline levels to a greater extent than the S\u2010ALP levels between 5 and 28M, corresponding to progressive improvement in the BMD. No fragility fractures or adverse events occurred, and remission of nephrotic syndrome was maintained. This case suggests that alendronate rapidly suppresses bone resorption, promotes a bone formation\u2010dominant state in conjunction with glucocorticoid tapering and may prevent bone fragility in paediatric GIOP. A \u2265\u200934% increase in S\u2010TRACP\u20105b accompanied by a \u2265\u200922% decrease in S\u2010ALP from baseline may indicate the appropriate timing for initiating antiresorptive treatment. Further investigations are warranted to establish evidence\u2010based management strategies for paediatric GIOP.<\/jats:p>","DOI":"10.1111\/nep.70245","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T01:05:27Z","timestamp":1783386327000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of Antiresorptive Treatment on Bone Mineral Density and Bone Turnover Markers in a Child With Steroid\u2010Resistant Nephrotic Syndrome: A Case Report"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6899-6797","authenticated-orcid":false,"given":"Jun","family":"Aoyagi","sequence":"first","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Kanai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takane","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4447-7786","authenticated-orcid":false,"given":"Masanori","family":"Kurosaki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomomi","family":"Maru","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marika","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Shimotsuke 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