Clinical Case: Pregnancy lactation osteoporosis

Loukadaki, Olga; Tournis, Symeon; Gazi, S.

doi:10.31138/mjr.28.3.161

Cited by 6 publications

(3 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Breastfeeding produces an obligatory loss of maternal skeletal mineral which contributes to the decline of bone density [16]. All women with developed PLO are advised to stop breastfeeding.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy- and lactation-associated osteoporosis with vertebral fractures

Bozovic¹,

Elek²,

Jovanović³

et al. 2021

Srp Arh Celok Lek

View full text Add to dashboard Cite

Introduction. Pregnancy- and lactation- associated osteoporosis (PLO) is a rare disease for which the pathophysiological mechanism is as yet incompletely known. The incidence of PLO is 0.4 in 100,000 women. It is considered that the number of undiagnosed patients is even higher. PLO can lead to multiple fragility compression fractures in the spinal vertebrae. Case outline. We present the case of a 30 years old woman (first-born, breastfeeding child) who comes for examination due to lower back pain that occurs after childbirth without any apparent cause. The patient was found to have low levels of vitamin D and low bone mineral density on osteodensitometry (established osteoporosis). Magnetic resonance imaging (MRI) examination showed vertebral bodies fractures Th11, Th12 and L4. In therapy we used Vitamin D (800 iu/24 h), Alendronate (70 mg once weekly), calcium 1000 mg/24h and Thoracic Lumbar Sacral Orthosis (TLSO) as support to spine. After 12 months of treatment osteodensitometry findings were close to normal, control MRI showed no further collapse of vertebral bodies and clinical examination of spine was orderly. Conclusion. PLO is a rare clinical condition and it must be kept in mind in the differential diagnosis in patients having low back pain during or after pregnancy. Early diagnosis and treatment of PLO and regular follow-up of these cases are particularly important. The stability of the spine in patients with vertebral fractures must be carefully monitored as well as using the TLSO as a support for the spine.

show abstract

Section: Discussionmentioning

confidence: 99%

Pregnancy- and lactation-associated osteoporosis with vertebral fractures

Bozovic¹,

Elek²,

Jovanović³

et al. 2021

Srp Arh Celok Lek

View full text Add to dashboard Cite

show abstract

“…PLO is a rare condition which occurs predominantly in the first pregnancy (70 %), occurring in the last trimester of pregnancy or immediately postpartum [6]. Pregnancy and lactation are both high maintenance periods with regard to skeletal health.…”

Section: Introductionmentioning

confidence: 99%

Effect of Teriparatide on Subsequent Fracture and Bone Mineral Density in 47 Women with Pregnancy- and Lactation-associated Osteoporosis and Vertebral Fractures

Hadji

Mouzakiti

Kyvernitakis

2022

Geburtshilfe Frauenheilkd

View full text Add to dashboard Cite

Introduction Pregnancy- and lactation-associated osteoporosis (PLO) with predominantly vertebral fractures is a rare but severe disease which can occur in the last trimester of pregnancy or postpartum. The aim of the present study was to assess the impact of teriparatide on subsequent fractures and bone mineral density (BMD) in patients with PLO. Materials and Methods A total of 47 patients with PLO and postpartum spinal fractures (mean: 4 fractures) undergoing treatment with teriparatide were investigated. The data collection period was set between 2006 and 2018. All patients received a subcutaneous injection of 20 µg teriparatide once a day for 24 months as well as individually adapted vitamin D supplementation. After 24 months of treatment, all women received no further treatment and either had regular menstrual cycles or took oral contraceptives. Fractures were confirmed by X-ray or MRI. Changes in BMD from baseline were examined using serial DXA measurements. Results After 24 months of teriparatide treatment, we could demonstrate an increase in BMD at the lumbar spine, femoral neck and total hip of + 30.1%, + 11.7% and + 12.2% respectively (p < 0.001 for all). At 12 months after cessation of treatment, BMD remained stable compared to the 24-month measurements at the lumbar spine, femoral neck and total hip which showed non-significant changes of + 1.4%, + 2.6% and + 4.1% respectively. Out of the 47 patients with PLO with a mean of 4 existing fractures, 4 patients (7.8%) sustained a subsequent fracture, two after 3 – 5 months of treatment and two at > 6 months of treatment. Conclusion 24 months of treatment with teriparatide in women with PLO and multiple vertebral fractures significantly increased BMD, predominantly BMD of the spine. As patients were premenopausal, there was no significant decrease in BMD in the following 12 months after cessation of treatment.

show abstract

“…However, it should be stressed that Still's disease is quite different from rheumatoid arthritis and many times carries a very high inflammatory burden. Loukadaki et al 9 report on a patient with pregnancy/lactation osteoporosis and review this interesting topic. A 39-year-old woman developed severe osteoporosis after a tween pregnancy and breast-feeding her twins.…”

mentioning

confidence: 99%

Mediterranean Journal of Rheumatology September 2017 Highlights

Sakkas¹

2017

MJR

View full text Add to dashboard Cite

Clinical Case: Pregnancy lactation osteoporosis

Cited by 6 publications

References 7 publications

Pregnancy- and lactation-associated osteoporosis with vertebral fractures

Pregnancy- and lactation-associated osteoporosis with vertebral fractures

Effect of Teriparatide on Subsequent Fracture and Bone Mineral Density in 47 Women with Pregnancy- and Lactation-associated Osteoporosis and Vertebral Fractures

Mediterranean Journal of Rheumatology September 2017 Highlights

Contact Info

Product

Resources

About