Department of Rehabilitation Medicine, Catholic Kwandong University International St. Mary's Hospital and Catholic Kwandong University, College of Medicine, Incheon, Korea.
Medicine (Baltimore). 2021 Oct 29;100(43):e27615. doi: 10.1097/MD.0000000000027615.
Osteoporosis is a condition commonly observed in elderly and postmenopausal women. Pregnancy and lactation-induced osteoporosis are rare, and the development of severe vertebral fractures is uncommon. Postpartum thyroiditis (PPT) is a minor cause of osteoporosis. To the best of our knowledge, the development of osteoporosis associated with pregnancy has not yet been reported.
Here, we report a rare case of post-pregnancy osteoporosis-related multiple vertebral fractures associated with PPT. A 25-year-old woman developed lower back pain after her first delivery. She was then admitted to our medical center because of aggravated back pain.
On radiographic examination, she had multiple compressions of the lumbar spine. Bone mineral density was associated with osteoporosis. Laboratory tests, thyroid scans, and thyroid ultrasonography were performed. The patient was diagnosed with PPT.
The patient stopped lactating immediately. She was administered bisphosphate at 3 mg/3 months intravenously, elementary calcium at 1000 mg/day, and calcitriol 0.5 μg/day.
A month later, her pain was relieved by proper management and she could independently walk indoors.
PPT might play a role in aggravating post-pregnancy osteoporosis. It should be considered as a differential diagnosis in patients presenting with postpartum osteoporosis-related multiple spine fractures.
骨质疏松症是一种常见于老年和绝经后妇女的病症。妊娠和哺乳期骨质疏松症较为罕见，严重的椎体骨折也不常见。产后甲状腺炎（PPT）是导致骨质疏松症的一个较小原因。据我们所知，与妊娠相关的骨质疏松症的发展尚未有报道。
我们在此报告一例罕见的与 PPT 相关的产后骨质疏松症相关的多发性椎体骨折。一名 25 岁女性在首次分娩后出现腰痛。随后，她因腰痛加重而入住我们的医疗中心。
影像学检查显示她的多个腰椎出现压缩性骨折。骨密度与骨质疏松症相关。进行了实验室检查、甲状腺扫描和甲状腺超声检查。该患者被诊断为 PPT。
患者立即停止哺乳。给予她每 3 个月静脉注射 3 毫克双膦酸盐、每天 1000 毫克基础钙和 0.5 微克/天的骨化三醇。
一个月后，她的疼痛得到适当的治疗后得到缓解，可以在室内独立行走。
PPT 可能在加重产后骨质疏松症方面发挥作用。对于出现产后骨质疏松症相关多发性脊柱骨折的患者，应将其作为鉴别诊断之一。
