فهرست نشریات علمی دسترسی آزاد ایران

Pregnancy-associated osteoporosis (PLO) is characterized by low bone mineral density (BMD) during pregnancy and lactation, and affected women experience fragility fractures, usually occurring in the third trimester of pregnancy or early postpartum. Treatment of PLO includes cessation of breastfeeding, adequate calcium and vitamin D supplementation, and in cases of severe PLO with multiple vertebral fractures, persistent debilitating pain, pharmacotherapy with anti-resorptive such as bisphosphonates or anabolic drugs such as teriparatide. A 38-year-old patient who developed back pain in the eighth month of her first pregnancy, which continued until the last month and worsened after delivery referred to our center 6 months postpartum. The spine magnetic resonance imaging showed a compression fracture of L2-L4. Dual X-ray absorptiometry was performed with the Hologic QRD device, which confirmed the presence of osteoporosis. With a diagnosis of PLO breast feeding was stopped. Calcium supplementation with dose of 1000 mg/d and Denosumab 60 mg SC every 6 months and celecoxib 200 mg/d for control of back pain was started. Over the next 3 months, back pain subsided by 80%, and at repeat densitometry after 12 months and receiving 2 doses of Denosumab, L1-4 BMD increased by 26%. Our report, along with previous reports, suggests that Denosumab may be an effective drug in the treatment of PLO, but clinical trials are needed to confirm this.