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Clinical characteristics and bisphosphonates treatment of rare pregnancy- and lactation-associated osteoporosis.
- Source :
-
Clinical rheumatology [Clin Rheumatol] 2018 Nov; Vol. 37 (11), pp. 3141-3150. Date of Electronic Publication: 2018 Jun 26. - Publication Year :
- 2018
-
Abstract
- Pregnancy- and lactation-associated osteoporosis (PLO) is a rare disorder with poorly known etiology, pathophysiology, and therapy. We aimed to investigate the clinical characteristics of PLO and evaluate the effectiveness and safety of bisphosphonates on it. A total of 12 patients were diagnosed with PLO on the basis of medical history, bone mineral density (BMD), and/or fragility fractures during pregnancy and lactation. We investigated the clinical, biochemical, and radiological characteristics of patients. We assessed the effects of alendronate or zoledronic acid through observing the changes of bone turnover biomarkers and BMD during the treatment. Secondary osteoporosis was excluded by comprehensive differential diagnosis. The mean age of these patients was 31 ± 5 years old. All of these patients presented severe back pain. Multiple vertebral compression fractures (VCFs) were found in 10 patients, and the median (P25th, P75th) number of compressed vertebra was 3 (3, 5). Ten patients had vitamin D insufficiency or deficiency. Serum level of bone resorption marker (β-CTX with mean of 0.68 ± 0.41 ng/ml) was moderately higher than the normal range. BMD at lumbar spine, femoral neck, and total hip were low as 0.894 ± 0.153 g/cm <superscript>2</superscript> , 0.728 ± 0.090 g/cm <superscript>2</superscript> , and 0.728 ± 0.080 g/cm <superscript>2</superscript> , respectively. Either alendronate or zoledronic acid could effectively relieve bone pain, reduce β-CTX level, and increase BMD. PLO is a rare type of osteoporosis, which was characterized by increased bone resorption and decreased BMD, even VCFs. Bisphosphonate therapy was well tolerated and effective in management of PLO, but needed to be further verified in randomized controlled trial.
- Subjects :
- Adult
Alendronate therapeutic use
Back Pain drug therapy
Bone Density drug effects
Bone Remodeling drug effects
Female
Fractures, Compression etiology
Humans
Osteoporosis etiology
Pregnancy
Retrospective Studies
Spinal Fractures etiology
Vitamin D Deficiency
Zoledronic Acid therapeutic use
Bone Density Conservation Agents therapeutic use
Diphosphonates therapeutic use
Lactation
Osteoporosis drug therapy
Pregnancy Complications drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1434-9949
- Volume :
- 37
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Clinical rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 29946989
- Full Text :
- https://doi.org/10.1007/s10067-018-4185-0