Raffaetà Gloria, Mazzantini Maurizio, Menconi Agnese, Bottai Vanna, Falossi Francesca, Celauro Ilenia, Guido Giulio
Orthopaedic Clinic University of Pisa, Pisa, Italy.
Rheumatology Unit, University of Pisa, Italy.
Clin Cases Miner Bone Metab. 2014 May;11(2):136-8.
Pregnancy and lactation-associated osteoporosis (PAO) is a rare condition characterized by the occurrence of fragility fractures, most commonly vertebral, in late pregnancy or the early postpartum period. The prevalence, etiology and pathogenesis of this osteoporosis are unknown, although there are several hypotheses attempting to explain the etiopathogenesis of pregnancy associated osteoporosis. In this paper we present two cases of young women who developed severe PAO with vertebral fractures: a 42-year-old woman with a family history of osteoporosis, and a 21-year-old woman affected with myasthenia gravis. The case 1 presented fragility fracture of D12, L2, and L3. She did not have any disease causing osteoporosis. However, she had a positive familial history for osteoporosis and during pregnancy (12th week) she had a detached placenta, so bed rest was prescribed for two months. The case 2 presented multiple vertebral fracture. She was affected by myasthenia gravis, which was diagnosed two years before pregnancy, and treated with corticosteroid. In summary, pregnancy and lactation-induced osteoporosis, although it is a rare disorder, should be kept in mind when pregnant women or women in postpartum period develop persistent back pain and it is important to monitor the patients with risk factors or secondary causes of osteoporosis.
妊娠和哺乳期相关骨质疏松症（PAO）是一种罕见的病症，其特征是在妊娠晚期或产后早期发生脆性骨折，最常见的是椎体骨折。尽管有几种假说试图解释妊娠相关骨质疏松症的病因病机，但这种骨质疏松症的患病率、病因和发病机制尚不清楚。在本文中，我们报告了两例发生严重PAO并伴有椎体骨折的年轻女性病例：一例是有骨质疏松家族史的42岁女性，另一例是患有重症肌无力的21岁女性。病例1出现了第12胸椎、第2腰椎和第3腰椎的脆性骨折。她没有任何导致骨质疏松的疾病。然而，她有骨质疏松的家族史阳性，并且在妊娠期间（第12周）出现了胎盘早剥，因此医嘱卧床休息两个月。病例2出现了多发性椎体骨折。她患有重症肌无力，在妊娠前两年被诊断出，并接受了皮质类固醇治疗。总之，妊娠和哺乳期诱发的骨质疏松症虽然是一种罕见的疾病，但当孕妇或产后妇女出现持续背痛时应予以考虑，并且监测有骨质疏松风险因素或继发原因的患者很重要。
