Advertisement

Rheumatology International

, Volume 29, Issue 2, pp 197–201 | Cite as

A case report: pregnancy-induced severe osteoporosis with eight vertebral fractures

  • Onder OfluogluEmail author
  • Demet Ofluoglu
Case Report

Abstract

Osteoporosis associated with pregnancy and lactation is a rare condition. The prevalence, etiology and its pathogenesis is unknown. It causes one or more vertebral fractures with severe, prolonged back pain and height loss in affected women. Majority of the cases are seen in the third trimester or just after delivery in primagravid women. In this case report, a 30-year-old woman who had severe pregnancy-induced osteoporosis with 8 vertebral fractures was presented. During last month of her first pregnancy she had moderate back pain. After delivery, the back pain has gotten worse. The radiological examinations have shown that there was 50% in T6, T8 and T10; 30% in L2; 20% in L1 height loss and biconcave vertebral images in L3–5. In the bone mineral density, L2–4 T score was −4.7 and total femoral T score was −3.1. There was no abnormality in the laboratory findings except mild elevation in alkaline phosphates. Although pregnancy-associated osteoporosis is a rare condition, when pain occurs in the last trimester or early postpartum period, it should be considered in differential diagnosis.

Keywords

Bone Mineral Density Osteoporosis Back Pain Vertebral Fracture Alendronate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Khovidhunkit W, Epstein S (1996) Osteoporosis in pregnancy. Osteoporosis Int 6:345–354CrossRefGoogle Scholar
  2. 2.
    O’Sullivan SM, Grey AB, Singh R, Reid IR (2006) Biphosphonates in pregnancy and lactation-associated osteoporosis. Osteoporos Int 17:1008–1012PubMedCrossRefGoogle Scholar
  3. 3.
    Dunne F, Walters B, Marshall T, Heath DA (1993) Pregnancy associated osteoporosis. Clin Endocrinol 39:487–490CrossRefGoogle Scholar
  4. 4.
    Ghannam NN, Hammami MM, Bakheet SM, Khan BA (1999) Bone mineral density of the spine and femur in healthy Saudi females: relation to vitamin D status, pregnancy, and lactation. Calcif Tissue Int 65:23–28PubMedCrossRefGoogle Scholar
  5. 5.
    Holmberg-Marttila D, Sievanen H, Tuimala R (1999) Changes in bone mineral density during pregnancy and postpartum: prospective data on five women. Osteoporos Int 10:41–46PubMedCrossRefGoogle Scholar
  6. 6.
    Uemura H, Yasui T, Kiyokawa M, Kuwahara A, Kawa H, Matsuzaki T, Maegawa M, Furumoto H, Irahara M (2002) Serum osteoprotegerin/osteoclastogenesis-inhibitory factor during pregnancy and lactation and the relationship with calcium-regulating hormones and bone turnover markers. J Endocrinol 174:353–359PubMedCrossRefGoogle Scholar
  7. 7.
    Phillips AJ, Ostlere SJ, Smith R (2000) Pregnancy-associated osteoporosis: does the skeleton recover? Osteoporos Int 1:449–454CrossRefGoogle Scholar
  8. 8.
    Khovidhunkit W, Epstein S (1996) Osteoporosis in pregnancy. Osteoporosis Int 6:345–354CrossRefGoogle Scholar
  9. 9.
    Foster SA, Foley KA, Meadows ES, Johnston JA, Wang S, Pohl GM, Long SR (2008) Characteristics of patients initiating teriparatide for the treatment of osteoporosis. Osteoporosis Int 19(3):373–377CrossRefGoogle Scholar
  10. 10.
    Semler O, Land C, Schönau E (2007) Bisphosphonate therapy for children and adolescents with primary and secondary osteoporotic diseases. Orthopade 36(2):146–151PubMedCrossRefGoogle Scholar
  11. 11.
    Neer RM, Arnaud CD, Zanchetta JR et al (2001) Effect of parathyroid hormone (1–34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 344:1434–1441PubMedCrossRefGoogle Scholar
  12. 12.
    Forteo package insert (2002) Forteo (teriparatide) by Eli Lilly and Company. http://www.pi.lilly.com/us/forteo-pi.pdf
  13. 13.
    Mathis JM, Ortiz AO, Zoarski GH (2002) Vertebroplasty versus kyphoplasty. In: Mathis JM, Deramond H, Belkoff SM (eds) Percutaneous vertebroplasty and kyphoplasty, 2nd edn, Springer, Newyork, pp 145–156Google Scholar
  14. 14.
    Bayram S, Ozturk C, Sivrioglu K, Aydinli U, Kucukoglu S (2006) Kyphoplasty for pregnancy-associated osteoporotic vertebral fractures. Joint bone spine 73(5):564–566PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  1. 1.Department of OrthopedicsLutfi Kirdar Research HospitalIstanbulTurkey
  2. 2.Department of Physical Medicine and RehabilitationUniversal Hospitals GroupIstanbulTurkey

Personalised recommendations