Teriparatide and denosumab treatment for pregnancy and lactation-associated osteoporosis with multiple vertebral fractures: A case study

Objective: Pregnancy and lactation-associated osteoporosis (PLO) is a rare disease, which can lead to vertebral fractures in women of reproductive age. No treatment strategy for PLO has been established. Here we report a case of PLO treated with teriparatide followed by denosumab, in which remarkabl...

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Main Authors: Akifumi Ijuin, Hiromi Yoshikata, Ryoko Asano, Taku Tsuburai, Ritsuko Kikuchi, Hideya Sakakibara
Format: Article
Language:English
Published: Elsevier 2017-12-01
Series:Taiwanese Journal of Obstetrics & Gynecology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S102845591730267X
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spelling doaj-b6f43004641f4d05b3942553dc2d494f2020-11-24T23:51:15ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592017-12-0156686386610.1016/j.tjog.2017.10.028Teriparatide and denosumab treatment for pregnancy and lactation-associated osteoporosis with multiple vertebral fractures: A case studyAkifumi Ijuin0Hiromi Yoshikata1Ryoko Asano2Taku Tsuburai3Ritsuko Kikuchi4Hideya Sakakibara5Department of Obstetrics and Gynecology, Yokohama City University Hospital, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, JapanDepartment of Obstetrics and Gynecology, Yokohama City University Hospital, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, JapanDepartment of Obstetrics and Gynecology, Yokohama City University Hospital, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, JapanDepartment of Obstetrics and Gynecology, Yokohama City University Hospital, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, JapanDepartment of Obstetrics and Gynecology, Yokohama City University Hospital, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, JapanDepartment of Obstetrics and Gynecology, Yokohama City University Hospital, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, JapanObjective: Pregnancy and lactation-associated osteoporosis (PLO) is a rare disease, which can lead to vertebral fractures in women of reproductive age. No treatment strategy for PLO has been established. Here we report a case of PLO treated with teriparatide followed by denosumab, in which remarkable improvement in bone mineral density (BMD) was achieved. Case report: A 27-year-old woman experienced severe back pain two weeks after her first delivery. PLO was diagnosed from her low BMD and multiple vertebral compression fractures. She was treated with teriparatide for 6 months, followed by denosumab. After 1 year, her BMD increase from baseline was 16.5% in L2∼4 and her pain had been relieved. Conclusion: In addition to weaning, administration of teriparatide followed by denosumab led to remarkable improvement in the patient's symptoms and BMD. Therefore, we regard this method as a promising choice for the treatment of PLO.http://www.sciencedirect.com/science/article/pii/S102845591730267XDenosumabLactationOsteoporosisPregnancyTeriparatide
collection DOAJ
language English
format Article
sources DOAJ
author Akifumi Ijuin
Hiromi Yoshikata
Ryoko Asano
Taku Tsuburai
Ritsuko Kikuchi
Hideya Sakakibara
spellingShingle Akifumi Ijuin
Hiromi Yoshikata
Ryoko Asano
Taku Tsuburai
Ritsuko Kikuchi
Hideya Sakakibara
Teriparatide and denosumab treatment for pregnancy and lactation-associated osteoporosis with multiple vertebral fractures: A case study
Taiwanese Journal of Obstetrics & Gynecology
Denosumab
Lactation
Osteoporosis
Pregnancy
Teriparatide
author_facet Akifumi Ijuin
Hiromi Yoshikata
Ryoko Asano
Taku Tsuburai
Ritsuko Kikuchi
Hideya Sakakibara
author_sort Akifumi Ijuin
title Teriparatide and denosumab treatment for pregnancy and lactation-associated osteoporosis with multiple vertebral fractures: A case study
title_short Teriparatide and denosumab treatment for pregnancy and lactation-associated osteoporosis with multiple vertebral fractures: A case study
title_full Teriparatide and denosumab treatment for pregnancy and lactation-associated osteoporosis with multiple vertebral fractures: A case study
title_fullStr Teriparatide and denosumab treatment for pregnancy and lactation-associated osteoporosis with multiple vertebral fractures: A case study
title_full_unstemmed Teriparatide and denosumab treatment for pregnancy and lactation-associated osteoporosis with multiple vertebral fractures: A case study
title_sort teriparatide and denosumab treatment for pregnancy and lactation-associated osteoporosis with multiple vertebral fractures: a case study
publisher Elsevier
series Taiwanese Journal of Obstetrics & Gynecology
issn 1028-4559
publishDate 2017-12-01
description Objective: Pregnancy and lactation-associated osteoporosis (PLO) is a rare disease, which can lead to vertebral fractures in women of reproductive age. No treatment strategy for PLO has been established. Here we report a case of PLO treated with teriparatide followed by denosumab, in which remarkable improvement in bone mineral density (BMD) was achieved. Case report: A 27-year-old woman experienced severe back pain two weeks after her first delivery. PLO was diagnosed from her low BMD and multiple vertebral compression fractures. She was treated with teriparatide for 6 months, followed by denosumab. After 1 year, her BMD increase from baseline was 16.5% in L2∼4 and her pain had been relieved. Conclusion: In addition to weaning, administration of teriparatide followed by denosumab led to remarkable improvement in the patient's symptoms and BMD. Therefore, we regard this method as a promising choice for the treatment of PLO.
topic Denosumab
Lactation
Osteoporosis
Pregnancy
Teriparatide
url http://www.sciencedirect.com/science/article/pii/S102845591730267X
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