Bone Microarchitecture and Strength Changes During Teriparatide and Zoledronic Acid Treatment in a Patient with Pregnancy and Lactation-Associated Osteoporosis with Multiple Vertebral Fractures

Autor: Sanne Treurniet, Melissa S. A. M. Bevers, Caroline E. Wyers, Dimitra Micha, Bernd P. Teunissen, Mariet W. Elting, Joop P. van den Bergh, Elisabeth M. W. Eekhoff
Přispěvatelé: Internal medicine, Amsterdam Movement Sciences, Human genetics, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, AMS - Musculoskeletal Health, AMS - Tissue Function & Regeneration, Radiology and nuclear medicine, Amsterdam Reproduction & Development (AR&D), Amsterdam Gastroenterology Endocrinology Metabolism, RS: NUTRIM - R3 - Respiratory & Age-related Health, Interne Geneeskunde
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Treurniet, S, Bevers, M S A M, Wyers, C E, Micha, D, Teunissen, B P, Elting, M W, van den Bergh, J P & Eekhoff, E M W 2023, ' Bone Microarchitecture and Strength Changes During Teriparatide and Zoledronic Acid Treatment in a Patient with Pregnancy and Lactation-Associated Osteoporosis with Multiple Vertebral Fractures ', Calcified Tissue International, vol. 112, no. 5, pp. 621-627 . https://doi.org/10.1007/s00223-023-01066-3
Calcified Tissue International. Springer New York
Calcified Tissue International, 112(5), 621-627. Springer, Cham
Calcified Tissue International, 112(5), 621-627. Springer New York
ISSN: 0171-967X
DOI: 10.1007/s00223-023-01066-3
Popis: Pregnancy- and lactation-associated osteoporosis (PLO) is a rare form of osteoporosis, of which the pathogenesis and best treatment options are unclear. In this report, we describe the case of a 34-year old woman diagnosed with severe osteoporosis and multiple vertebral fractures after her first pregnancy, who was subsequently treated with teriparatide (TPTD) and zoledronic acid (ZA). We describe the clinical features, imaging examination, and genetic analysis. Substantial improvements were observed in areal and volumetric bone mineral density (BMD), microarchitecture, and strength between 7 and 40 months postpartum as assessed by dual-energy X-ray absorptiometry at the total hip and spine and by high-resolution peripheral quantitative CT at the distal radius and tibiae. At the hip, spine, and distal radius, these improvements were mainly enabled by treatment with TPTD and ZA, while at the distal tibiae, physiological recovery and postpartum physiotherapy due to leg pain after stumbling may have played a major role. Additionally, the findings show that, despite the improvements, BMD, microarchitecture, and strength remained severely impaired in comparison with healthy age- and gender-matched controls at 40 months postpartum. Genetic analysis showed no monogenic cause for osteoporosis, and it is suggested that PLO in this woman could have a polygenic origin with possible susceptibility based on familiar occurrence of osteoporosis.
Databáze: OpenAIRE
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