Compression Fracture in Postpartum Osteoporosis

Kim, Tae-Hee; Lee, Hae-Hyeog; Jeon, Dong-Su; Byun, Dong Won

doi:10.11005/jbm.2013.20.2.115

Cited by 8 publications

(8 citation statements)

References 10 publications

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“…There is no clinical guideline for the treatment of pregnancy-related osteoporosis. Traditional management of postpartum osteoporosis includes calcium and vitamin D supplementation and weaning [ 2 ]. But, calcium and vitamin D deficiency is not a universal finding [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Pregnancy-related osteoporosis and spinal fractures

et al. 2017

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Pregnancy-related osteoporosis is a very rare condition characterized by the occurrence of fracture during pregnancy or the puerperium. Despite its relative rarity, it can be a dangerous condition that causes severe back pain, height loss and disability. Normal physiologic changes during pregnancy, genetic or racial difference, obstetrical history and obstetrical disease, such as preterm labor or pregnancy-induced hypertension, are presumed risk factors of pregnancy-related osteooporosis. However, exact etiology and pathogenesis are uncertain. The management and natural history are still poorly defined. Traditional medications for osteoporosis are calcium/vitamin D and bisphosphonate. Concerns with bisphosphonate include accumulation in bone and fetal exposure in subsequent pregnancies. The newly developed medication, teriparatide, has shown good results. We report six cases of pregnancy-related osteoporosis and spinal fracture with literature review.

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Section: Discussionmentioning

confidence: 99%

“…It is characterized by low bone mass, deterioration of bone tissue and disruption of bone architecture, compromised bone strength and an increase in the risk of fracture [ 1 ]. The prevalence of osteoporosis is less than 2% in women younger than 50 years and only 1.2% between the ages of 20 and 40 years [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Pregnancy-related osteoporosis and spinal fractures

et al. 2017

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“…[6] The absorption of calcium returns to prepregnancy levels and estrogen level reduces, along with reduced excretion of calcium in urine. The exact etiology and pathogenesis of pregnancy and lactation-associated osteoporosis still remains unknown; however, a few proposed factors are hypoestrogenemia during breastfeeding, fetal calcium intake from the mother,[7] excessive parathyroid hormone-related peptide released from the lactating breast into the maternal circulation,[89] and calcitonin deficiency which exacerbates the normal loss of calcium during lactation. [10] There could be a loss in BMD in the range of 5%–14%[1112]…”

Section: Discussionmentioning

confidence: 99%

Spinal compression fractures due to pregnancy-associated osteoporosis

Krishnakumar

Kumar

Kuzhimattam

2016

J Craniovert Jun Spine

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Objectives:To report on unique cases of spinal compression fractures due to pregnancy-associated osteoporosis (PAO) and to suggest a satisfactory treatment modality.Materials and Methods:A single-center retrospective study. We reviewed the data of 535 patients with osteoporotic spinal compression fractures over a period of 5-year. Two patients who developed spinal compression fractures due to PAO were identified and treated.Results:The clinical presentation and blood investigations ruled out other causes of osteoporosis. Dual-energy X-ray absorptiometry was used to confirm the diagnosis. All patients improved with medical management.Conclusion:Vertebral fractures due to PAO should be considered as a differential diagnosis in patients with back pain who are in the third trimester of pregnancy or in postpartum. Early recognition and appropriate conservative management would be necessary to prevent complications such as new vertebral fractures and chronic back pain.

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“…They also hypothesized that estrogen increases the activity of the enzyme responsible for activating vitamin D; we agree with their hypothesis. Administration of estradiol increases the expression of estrogen receptor (which maintains bone strength and bone health) and vitamin D. 2 Vitamin D stimulates estradiol biosynthesis in ovaries and in cells pretreated with noncalcemic analogs, which increases the expression of estrogen receptor-> protein. 3 What exactly increases the synergistic effect of estrogen and vitamin D?…”

Section: Letters To the Editormentioning

confidence: 99%

“…A score of 0 or 1 has a sensitivity of 100%, a specificity of 45%, and a negative predictive value of 100%; a score of 4 has only 14% sensitivity for the diagnosis of septal fibrosis and cirrhosis. 2,3 In other words, the presence of one factor (or the absence of factors) excludes septal fibrosis or cirrhosis in women with NAFLD, but a lack of elevated scores does not rule out advanced fibrosis. In fact, Ratziu et al, 4 who first proposed BAAT score, replaced this test with FibroTest-FibroSURE because of the low sensitivity of the …”

Section: To the Editormentioning

confidence: 99%

Letters to the Editor

2015

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Vitamin D is currently a hot issue for physicians and the public. Vitamin D level is closely correlated with bone health, and many recent reports on 25-hydroxyvitamin D [25(OH)D] levels and cardiovascular disease, inflammation, depression, cancer, pelvic pain, and other conditions have been published. Physicians who treat postmenopausal women reporting sleep disturbances, emotional depression, or chronic fatigue are curious about whether adding vitamin D supplementation to hormone therapy would lead to a synergistic effect on relieving these symptoms. After vitamin D supplementation and hormone therapy had been prescribed to women with serum 25(OH)D levels indicative of vitamin D deficiency, some reported a decrease in menopause-related symptoms. LeBlanc et al 1 concluded that there is no evidence linking 25(OH)D levels and menopauserelated symptoms in postmenopausal women. They also hypothesized that estrogen increases the activity of the enzyme responsible for activating vitamin D; we agree with their hypothesis. Administration of estradiol increases the expression of estrogen receptor (which maintains bone strength and bone health) and vitamin D. 2 Vitamin D stimulates estradiol biosynthesis in ovaries and in cells pretreated with noncalcemic analogs, which increases the expression of estrogen receptor-> protein. 3 What exactly increases the synergistic effect of estrogen and vitamin D? Why are there differences (including ethnic differences) in improvement of menopausal symptoms with vitamin D and hormone therapy among women? We believe that vitamin D affects estrogen levels and that estrogen levels also affect vitamin D levels. We have hypothesized that the vitamin D receptor (VDR) itself and VDR genetic polymorphisms have different effects on women. VDR is a member of a superfamily of nuclear receptors; it mediates the actions of vitamin D. Membrane signaling can be correlated with nongenomic effects of VDR; correlations and effects of vitamin D levels on diseases and conditions such as cancer, immunity, bone pain, cardiovascular disease, and depression have been reported. However, reports on potential effects of VDR on diseases are rare. Another hypothesis is that VDR gene polymorphisms affect menopause-related symptoms. Postmenopausal women and their physicians want evidence-based data on whether levels of vitamin D and estrogen have a synergistic effect on menopauserelated symptoms or other conditions. Therefore, further research on VDR gene polymorphisms and the relationship between VDR or serum vitamin D levels and health conditions, including menopausal symptoms, should be performed. REFERENCES 1. LeBlanc ES, Desai M, Perrin N, et al. Vitamin D levels and menopauserelated symptoms. Menopause 2014;21:1197-1203. 2. Kim TH, Lee HH, Jeon DS, Byun DW. Compression fracture in postpartum osteoporosis. J Bone Metab 2013;20:115-118. 3. Somjen D, Kohen F, Gayer B, et al. A non-calcemic vitamin D analog modulates both nuclear and putative membranal estrogen receptors in cultured human vascular smooth muscle cell...

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Compression Fracture in Postpartum Osteoporosis

Cited by 8 publications

References 10 publications

Pregnancy-related osteoporosis and spinal fractures

Pregnancy-related osteoporosis and spinal fractures

Spinal compression fractures due to pregnancy-associated osteoporosis

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