RSS-Feed abonnieren
DOI: 10.1055/s-2007-967091
The Use of i. v. Bisphosphonate in Pregnancy-Associated Osteoporosis - Case Study
Publikationsverlauf
received 20. 12. 2005
first decision 29. 05. 2006
accepted 2. 06. 2006
Publikationsdatum:
22. Februar 2007 (online)
Abstract
Objective: Diagnosis of pregnancy-associated osteoporosis is often delayed and therapeutic interventions insufficient.
Study design: A 28-year-old patient (BMI=18.6) with no additional risks for osteoporosis experienced acute lumbosacral pain two months postpartum, while lactating. After conservative therapy, thoracic and lumbar spine were X-rayed: severe pregnancy-associated osteoporosis with vertebral fractures was diagnosed. 2-year treatment with i. v. bisphosphonate ibandronate was initiated (2 mg every 3 months) and calcium and vitamin D supplementation.
Results: Rapid improvement was observed. Conclusion: In cases with multiple fractures i. v. bisphosphonate leads to substantial decrease of symptoms and further fractures and significant increase of bone mass density (BMD).
Conclusion: In severe cases of pregnancy-associated osteoporosis with multiple fractures i. v. biphosphonate therapy leads to a decrease of symptoms and fracture risk and an increase of bone mass density (BMD).
Key words
alimentation - hormones - metabolic features
References
- 1 Bartl R. Osteoporose. Internist. 2002; 43 1529-1543
- 2 Dunne F, Walters B, Marshall T, Heath DA. Pregnancy associated osteoporosis. Clin Endocrinol. 1993; 39 487-490
- 3 Eisman J. Relevance of pregnancy and lactation to osteoporosis? Commentary. Lancet. 1998; 352 504-505
- 4 Gallacher SJ, Fraser WD, Owens OJ. et al . Changes in calciotrophic hormones and biochemical markers of bone turnover in normal human pregnancy. Eur J Endocrinol. 1994; 131 369-374
- 5 Hadji P, Bock K, Emons G, Wüster C, Schulz KD. Früherkennung und Prävention der Osteoporose. Gynäkologe. 2002a; 35 518-526
- 6 Hadji P, Bock K, Wüster C, Emons G, Gottschalk M, Schulz KD. Osteodensitometrie: Quo vadis?. Reproduktionsmedizin. 2001; 17 261-270
- 7 Hadji P, Ziller V, Kalder M. et al . Influence of pregnancy and breastfeeding on quantitative ultrasonometry of bone in postmenopausal women. Climacteric. 2002b; 5 277-285
- 8 Haram K, Thodarson H, Hervig T. Calcium homeostasis in pregnancy and lactation. Acta Obstet Gynaecol Scand. 1993; 72 509-513
- 9 Hellmeyer l, Hadji P, Ziller V, Wagner U, Schmidt S. Osteoporose in der Schwangerschaft. Geburtsh Frauenheilk. 2004; 64 38-45
- 10 Levav AL, Chan l, Wapner RJ. Long-term magnesium sulfate tocolysis and maternal osteoporosis in a triplet pregnancy: A case report. Am J Perinatol. 1998; 15 43-46
- 11 Munns CFJ, Rauch F, Ward L, Glorieux FH. Maternal and fetal outcome after long-term pamidronate treatment before conception: A report of two cases. JBMR. 2004; 19 1742-1745
- 12 Phillips AJ, Ostlere SJ, Smith R. Pregnancy-associated osteoporosis: does the skeleton recover?. Osteoporos Int. 2000; 11 449-454
- 13 Saraux A, Bourgeais F, Erhart A, Baron D, Le Goff P. Ostéoporose de lagrossesse: quatre obversations. Rev Rhum Ed Fr. 1993; 60 596-600
- 14 Smith R, Athanasou NA, Ostlere SJ, Vipond SE. Pregnancy-associated osteoporosis. Q J Med. 1995; 88 865-878
Correspondence
L. Hellmeyer
Department of Obstetrics and Perinatal Medicine
Philipps-University of Marburg
Pilgrimstein 3
35037 Marburg
Germany
Telefon: +49/642/12 86 44 04
Fax: +49/642/12 86 45 43
eMail: hellmeye@med.uni-marburg.de