OBJECTIVE: To analyze the clinical features of pregnancy and lactation-associated osteoporosis (PLO). METHODS: The clinical data of 4 patients with PLO were retrospectively analyzed. RESULTS: Bone pain and limitation of motion appeared within 2 months after childbirth in these 4 patients. X-ray films showed multiple vertebral fractures of thoracic and/or lumbar spine. Three of the 4 patients had positive family history of osteoporosis or low trauma fractures. After the diagnosis of PLO was confirmed, lactation was discontinued, and treatment of calcium, active vitamin D analogues, and bisphosphonates were initiated. After these managements, no new fracture occurred and the BMD at L(2-4) was markedly increased by 12.7% - 22.7% during their follow-up period of 1 - 4 years. CONCLUSION: Women with positive family history of osteoporosis or low trauma fractures may be susceptible to PLO. PLO should be considered when lumbar or back pain occur during pregnancy and lactation. Besides calcium and active vitamin D analogues, anti-resorptive agents (bisphosphonate or calcitonin) may be effective on PLO.
OBJECTIVE: To analyze the clinical features of pregnancy and lactation-associated osteoporosis (PLO). METHODS: The clinical data of 4 patients with PLO were retrospectively analyzed. RESULTS: Bone pain and limitation of motion appeared within 2 months after childbirth in these 4 patients. X-ray films showed multiple vertebral fractures of thoracic and/or lumbar spine. Three of the 4 patients had positive family history of osteoporosis or low trauma fractures. After the diagnosis of PLO was confirmed, lactation was discontinued, and treatment of calcium, active vitamin D analogues, and bisphosphonates were initiated. After these managements, no new fracture occurred and the BMD at L(2-4) was markedly increased by 12.7% - 22.7% during their follow-up period of 1 - 4 years. CONCLUSION:Women with positive family history of osteoporosis or low trauma fractures may be susceptible to PLO. PLO should be considered when lumbar or back pain occur during pregnancy and lactation. Besides calcium and active vitamin D analogues, anti-resorptive agents (bisphosphonate or calcitonin) may be effective on PLO.
Authors: Martin Gehlen; Ana Doina Lazarescu; Christian Hinz; Michael Schwarz-Eywill; Michael Pfeifer; Subathira Balasingam; Anna Maier Journal: Clin Rheumatol Date: 2019-08-29 Impact factor: 2.980