Effect of teriparatide on pregnancy and lactation-associated osteoporosis with multiple vertebral fractures

Choe, Eun Yeong; Song, Je Eun; Park, Kyeong Hye; Seok, Hannah; Lee, Mi Kyung; Lim, Sung Kil; Rhee, Yumie

doi:10.1007/s00774-011-0334-0

Cited by 79 publications

(54 citation statements)

References 25 publications

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“…To our knowledge, there are three articles reporting the outcomes of TRP treatment in PLO. 2,23,24 In one patient, after 18 months of therapy, the increase of BMD at the spine and total hip was 36% and 13.8%, respectively. 24 In a small case series, three PLO patients improved their BMD by 14.5-25% at the lumbar spine and 13.4-17.9% at the total hip.…”

Section: Discussionmentioning

confidence: 96%

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Case Report: Teriparatide treatment in a case of severe pregnancy -and lactation- associated osteoporosis

Lampropoulou-Adamidou¹,

Trovas²,

Stathopoulos³

et al. 2012

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OBJEcTIVE: Pregnancy-and lactation-associated osteoporosis (PLO) is an uncommon disease. The majority of cases are seen in the third trimester or early post-partum in primagravid women and the prominent clinical feature of PLO is severe and prolonged back pain and height loss. The prevalence and aetiology of this disorder are as yet unclear and there are no guidelines for its treatment. cAsE rEPOrT: We report the outcomes of teriparatide (TrP) treatment in a woman suffering from severe PLO with 6 vertebral fragility fractures, severe back pain and very low BMD. rEsULTs: Thirteen months after the initiation of therapy, the patient was almost free of back pain. There was no new clinical vertebral fracture. Her laboratory tests were all normal. BMD increased by 24.4% at the lumbar spine, 9.9% and 4.6% at the left and the right total hip and 12.6% and 7.8% at the left and right femur neck, respectively. cONcLUsION: TrP treatment simultaneously with weaning and calcium and vitamin D supplementation seems to considerably increase BMD, improve severe back pain and quality of life and prevent further occurrence of vertebral fractures, making TrP a helpful tool in restoring bone strength in PLO patients. Key words: Lactation, Osteoporosis, Pregnancy, Premenopausal osteoporosis, TeriparatideCase report HORMONES 2012, 11(4):495-500 Address for correspondence: Kalliopi Lampropoulou-Adamidou, MD, MSc, Laboratory for the Research of the Musculoskeletal System "Th. Garofalidis", KAT General Hospital of Athens, 10 Athinas Str., 14561, Kifissia, Athens, Greece, Tel.: +306984229202, +302108018123, Fax: +302108018122, E-mail: kilampropoulou@gmail.com of PLO was made by Nordin et al in 1955. 1 It is characterised by the occurrence of fragility fracture(s), most commonly involving the lower thoracic and/ or lumbar vertebral bodies. The majority of cases are seen in the third trimester or early post-partum in primagravid women and the prominent clinical feature of PLO is severe and prolonged back pain and height loss. The prevalence and the ae tiology of this disorder are unclear. To date, more than 120 cases have been reported, mostly as individual case reports.2 Due to the lack of controlled trials and the rarity of the disease there are no formal guidelines.

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Section: Discussionmentioning

confidence: 96%

“…To date, more than 120 cases have been reported, mostly as individual case reports. 2 Due to the lack of controlled trials and the rarity of the disease there are no formal guidelines.…”

mentioning

confidence: 99%

Case Report: Teriparatide treatment in a case of severe pregnancy -and lactation- associated osteoporosis

Lampropoulou-Adamidou¹,

Trovas²,

Stathopoulos³

et al. 2012

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“…The recent use of teriparatide has been followed by a remarkable increase in BMD at both the spine and the hip in a few cases with vertebral fractures diagnosed at post partum or within the lactation period (97,98,99).…”

Section: -454 With Permission) European Journal Of Endocrinologymentioning

confidence: 99%

ENDOCRINOLOGY IN PREGNANCY: Bone metabolic changes during pregnancy: a period of vulnerability to osteoporosis and fracture

Sanz-Salvador

Garcı́a-Pérez

Tarı́n

et al. 2015

European Journal of Endocrinology

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Changes in bone density and bone markers suggest that pregnancy is associated with deterioration of bone mass in the mother. The metabolism of calcium resets to allow for the needs imposed by the building of the fetal skeleton. The fetus contributes to the process through the output of regulators from the placenta. Understanding of the whole process is limited, but some changes are unambiguous. There is an increase in the circulating levels of vitamin D, but its functional impact is unclear. Fetal parathyroid hormone (PTH) and PTH-related peptide (PTHrp) play an indirect role through support of a calcium gradient that creates hypercalcemia in the fetus. Placental GH, which increases up to the end of pregnancy, may exert some anabolic effects, either directly or through the regulation of the IGF1 production. Other key regulators of bone metabolism, such as estrogens or prolactin, are elevated during pregnancy, but their role is uncertain. An increase in the ratio of receptor activator of nuclear factor kappa B ligand (RANKL) to osteoprotegerin (OPG) acts as an additional pro-resorbing factor in bone. The increase in bone resorption may lead to osteoporosis and fragility fracture, which have been diagnosed, although rarely. However, the condition is transitory as long-term studies do not link the number of pregnancies with osteoporosis. Prevention is limited by the lack of identifiable risk factors. When fractures are diagnosed, rest, analgesics, or, when indicated, orthopedic intervention have demonstrated efficacy. Systemic treatment with anti-osteoporotic drugs is effective, but the potential harm to the fetus imposes caution in their use.

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“…Süt yoluyla günlük 250 mg kalsiyum kaybedilebilir. Emzirme süresince kemik döngüsü artar, süt yolu ile kalsiyum kaybedilmesine karşın idrarla atılan kalsiyum miktarı azalır (5,17). Emzirmeyi kesip sadece kalsiyum ve D vitamini takviyesi verilen olguların lomber KMY değerlerinde 8-18 ayda %6, 2-4 yıllık süre de %9,5 artış tespit edilmiştir (12,18).…”

Section: Discussionunclassified

“…Kompresyon kırıkları en sık olarak, alt torakal (T) vertebralar ile lomber vertebralarda görülür (2,3). Bu az görülen osteoporoz formu ile ilgili literatürde 120 civarında olgu sunulmuştur (4,5). GİO'nun insidansı kadınlarda 0,4/100,000 olarak belirtilmekle beraber, tanı almamış hastaların sayısının da yüksek olduğu düşünülmektedir (6,7).…”

Section: Introductionunclassified

A Rare Cause of Low Back Pain in Pregnancy: Pregnancy Associated Osteoporosis

Yetişgin¹,

Dokumaci²,

Eren³

et al. 2016

Tod

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SummaryPregnancy associated osteoporosis is a rare entity seen at the third trimester of first pregnancy or early postpartum period. It does not recur frequently in the subsequent pregnancies; however, it might lead to various complications unless it is treated. In this paper, we presented a woman diagnosed with pregnancy-associated osteoporosis with back pain at the 6 th month of the pregnancy in order to discuss the points to be taken into consideration in the diagnosis/differential diagnosis and treatment options of pregnancy associated osteoporosis. Keywords: Pregnancy associated osteoporosis, pregnancy, lactation, low back pain Gebelikte Görülen Bel Ağrısının Nadir Bir Nedeni: Gebelikle İlişkili Osteoporoz A Rare Cause of Low Back Pain in Pregnancy: Pregnancy Associated OsteoporosisGebelikle ilişkili osteoporoz, genellikle ilk gebeliğin son trimesteri ile doğum sonrası ilk aylarda görülebilen nadir bir klinik durumdur. Sonraki gebeliklerde sıklıkla tekrarlamaz ve tedavi edilmezse birçok komplikasyona neden olabilir. Bu yazıda, gebeliğinin 6. ayında şiddetli bel ağrısı şikayeti başlayan ve gebelikle ilişkili osteoporoz tanısı konulan bir hasta sunularak, tanı/ayırıcı tanıda dikkat edilmesi gereken konular ile tedavi seçeneklerini tartıştık.

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Effect of teriparatide on pregnancy and lactation-associated osteoporosis with multiple vertebral fractures

Cited by 79 publications

References 25 publications

Case Report: Teriparatide treatment in a case of severe pregnancy -and lactation- associated osteoporosis

Case Report: Teriparatide treatment in a case of severe pregnancy -and lactation- associated osteoporosis

ENDOCRINOLOGY IN PREGNANCY: Bone metabolic changes during pregnancy: a period of vulnerability to osteoporosis and fracture

A Rare Cause of Low Back Pain in Pregnancy: Pregnancy Associated Osteoporosis

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