| Literature DB >> 20173778 |
JoAnn V Pinkerton1, Alan C Dalkin, Sheila E Crowe, Barbara B Wilson, Edward B Stelow.
Abstract
BACKGROUND: A 62-year-old postmenopausal woman with a family history of breast cancer, mild gastroesophageal reflux disease, iron-deficient anemia and declining BMD was seen in a specialist center for the evaluation and management of osteoporosis. INVESTIGATIONS: Analysis of tissue transglutaminase IgA, endoscopic biopsy, serial BMD scans, FRAX calculation of osteoporotic fracture risk, Gail model calculation of breast cancer risk, assessment of blood vitamin D concentration and secondary evaluation for osteoporosis. DIAGNOSIS: Osteoporosis, persistent after 12 years of hormone replacement therapy, and celiac disease. MANAGEMENT: The patient was initially treated for bone loss with postmenopausal hormone replacement therapy. DXA analyses showed a continued decline in BMD despite adequate replacement of calcium and vitamin D levels and withdrawal of gluten from the patient's diet. An oral bisphosphonate was recommended with plans to reassess BMD after 1 year.Entities:
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Year: 2010 PMID： 20173778 DOI： 10.1038/nrendo.2009.272
Source DB: PubMed Journal: Nat Rev Endocrinol ISSN： 1759-5029 Impact factor: 43.330