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Pregnancy and Lactation-Associated Osteoporosis Successfully Treated with Romosozumab: A Case Report

Pregnancy- and lactation-associated osteoporosis (PLO) is a rare type of premenopausal osteoporosis that occurs mainly in the third trimester or immediately after delivery; one of its most common symptoms is back pain caused by a vertebral fracture. The pathogenesis of PLO is unclear, and there is n...

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Autores principales: Kaneuchi, Yoichi, Iwabuchi, Masumi, Hakozaki, Michiyuki, Yamada, Hitoshi, Konno, Shin-ichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862917/
https://www.ncbi.nlm.nih.gov/pubmed/36676643
http://dx.doi.org/10.3390/medicina59010019
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author Kaneuchi, Yoichi
Iwabuchi, Masumi
Hakozaki, Michiyuki
Yamada, Hitoshi
Konno, Shin-ichi
author_facet Kaneuchi, Yoichi
Iwabuchi, Masumi
Hakozaki, Michiyuki
Yamada, Hitoshi
Konno, Shin-ichi
author_sort Kaneuchi, Yoichi
collection PubMed
description Pregnancy- and lactation-associated osteoporosis (PLO) is a rare type of premenopausal osteoporosis that occurs mainly in the third trimester or immediately after delivery; one of its most common symptoms is back pain caused by a vertebral fracture. The pathogenesis of PLO is unclear, and there is no accepted consensus regarding the treatment of PLO. Although treatments with drugs such as bisphosphonate, strontium ranelate, denosumab, and teriparatide were reported, there is no report of a patient with PLO treated with romosozumab. We present the first case of a patient with PLO treated with romosozumab following 4-month teriparatide treatment. A 34-year-old primiparous and breastfeeding Japanese woman experienced severe low back pain 1 month postdelivery. She was diagnosed with PLO on the basis of low bone marrow density (BMD) and multiple vertebral fractures with no identified cause of secondary osteoporosis. She was treated with teriparatide injection for 4 months, but the treatment was discontinued because of the patient feeling severe nausea after every teriparatide injection and the appearance of new vertebral fractures. Thereafter, we used romosozumab for 12 months. After the romosozumab treatment, her BMD was increased from the baseline by 23.6% at L1–L4, 6.2% at the femoral neck, and 11.2% at the total hip. Treating PLO with 12-month romosozumab after 4 months of teriparatide injection remarkably increased the BMD of the lumbar spine, femoral neck, and total hip without subsequent fracture. Romosozumab has potential as a therapeutic option to improve the BMD and reduce the subsequent fracture risk of patients with PLO.
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spelling pubmed-98629172023-01-22 Pregnancy and Lactation-Associated Osteoporosis Successfully Treated with Romosozumab: A Case Report Kaneuchi, Yoichi Iwabuchi, Masumi Hakozaki, Michiyuki Yamada, Hitoshi Konno, Shin-ichi Medicina (Kaunas) Case Report Pregnancy- and lactation-associated osteoporosis (PLO) is a rare type of premenopausal osteoporosis that occurs mainly in the third trimester or immediately after delivery; one of its most common symptoms is back pain caused by a vertebral fracture. The pathogenesis of PLO is unclear, and there is no accepted consensus regarding the treatment of PLO. Although treatments with drugs such as bisphosphonate, strontium ranelate, denosumab, and teriparatide were reported, there is no report of a patient with PLO treated with romosozumab. We present the first case of a patient with PLO treated with romosozumab following 4-month teriparatide treatment. A 34-year-old primiparous and breastfeeding Japanese woman experienced severe low back pain 1 month postdelivery. She was diagnosed with PLO on the basis of low bone marrow density (BMD) and multiple vertebral fractures with no identified cause of secondary osteoporosis. She was treated with teriparatide injection for 4 months, but the treatment was discontinued because of the patient feeling severe nausea after every teriparatide injection and the appearance of new vertebral fractures. Thereafter, we used romosozumab for 12 months. After the romosozumab treatment, her BMD was increased from the baseline by 23.6% at L1–L4, 6.2% at the femoral neck, and 11.2% at the total hip. Treating PLO with 12-month romosozumab after 4 months of teriparatide injection remarkably increased the BMD of the lumbar spine, femoral neck, and total hip without subsequent fracture. Romosozumab has potential as a therapeutic option to improve the BMD and reduce the subsequent fracture risk of patients with PLO. MDPI 2022-12-22 /pmc/articles/PMC9862917/ /pubmed/36676643 http://dx.doi.org/10.3390/medicina59010019 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Kaneuchi, Yoichi
Iwabuchi, Masumi
Hakozaki, Michiyuki
Yamada, Hitoshi
Konno, Shin-ichi
Pregnancy and Lactation-Associated Osteoporosis Successfully Treated with Romosozumab: A Case Report
title Pregnancy and Lactation-Associated Osteoporosis Successfully Treated with Romosozumab: A Case Report
title_full Pregnancy and Lactation-Associated Osteoporosis Successfully Treated with Romosozumab: A Case Report
title_fullStr Pregnancy and Lactation-Associated Osteoporosis Successfully Treated with Romosozumab: A Case Report
title_full_unstemmed Pregnancy and Lactation-Associated Osteoporosis Successfully Treated with Romosozumab: A Case Report
title_short Pregnancy and Lactation-Associated Osteoporosis Successfully Treated with Romosozumab: A Case Report
title_sort pregnancy and lactation-associated osteoporosis successfully treated with romosozumab: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862917/
https://www.ncbi.nlm.nih.gov/pubmed/36676643
http://dx.doi.org/10.3390/medicina59010019
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