[妊娠和哺乳期骨质疏松:危险因素和治疗]。

IF 0.9 4区 医学 Q4 RHEUMATOLOGY
Zeitschrift fur Rheumatologie Pub Date : 2025-03-01 Epub Date: 2025-02-20 DOI:10.1007/s00393-025-01619-x
Katja Warnecke, Burkhard Muche, Andreas Krause, Paula Hoff
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引用次数: 0

摘要

妊娠及哺乳期骨质疏松症(PLO)是一种罕见但严重的疾病。经常发生多处骨折,主要以椎体骨折的形式,母亲受到严重限制,没有帮助几乎不可能照顾婴儿。骨折引起的抱怨通常发生在第一次怀孕的最后三个月或在哺乳期的第一周。磁共振成像(MRI)可用于检测椎体骨折和椎骨水肿。骨密度测定有助于诊断和评估进展。将PLO与其他继发性骨质疏松症区分开来是非常重要的,这些骨质疏松症也可以在妊娠和哺乳期表现出来。建议母亲立即停止母乳喂养,以阻止钙从骨骼中迁移,并使激素水平正常化。应补充钙和维生素D,并开始适当的疼痛治疗和物理治疗。由于这种疾病的罕见性,数据质量很差,所有可用的抗骨质疏松药物都在病例报告中使用过,但总的来说,在过去的十年中,特立帕肽的非适应症治疗已被证明是有益和安全的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Pregnancy and lactation-associated osteoporosis: risk factors and treatment].

Pregnancy and lactation-associated osteoporosis (PLO) is a rare but serious condition. Multiple fractures often occur, mostly in the form of vertebral fractures, the mother is severely restricted and caring for the infant is barely possible without assistance. The fractures causing the complaints usually occur in the last trimester of the first pregnancy or in the first weeks of lactation. Magnetic resonance imaging (MRI) can be used to detect vertebral fractures and also edematous vertebrae. Bone densitometry is helpful for the diagnostics and assessment of progression. It is extremely important to distinguish PLO from other secondary forms of osteoporosis that can also be manifested during pregnancy and lactation. The mother is advised to stop breastfeeding immediately in order to interrupt calcium mobilization from bone and to achieve a normalization of hormone levels. Calcium and vitamin D should be supplemented and adequate pain treatment and physiotherapy should be initiated. The quality of data is poor due to the rarity of the disease, all available anti-osteoporotic drugs have been used in case reports but overall, in the last decade off-label treatment with teriparatide has been proven to be helpful and safe.

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来源期刊
Zeitschrift fur Rheumatologie
Zeitschrift fur Rheumatologie 医学-风湿病学
CiteScore
2.20
自引率
20.00%
发文量
150
审稿时长
6-12 weeks
期刊介绍: Die Zeitschrift für Rheumatologie ist ein international angesehenes Publikationsorgan und dient der Fortbildung von niedergelassenen und in der Klinik tätigen Rheumatologen. Die Zeitschrift widmet sich allen Aspekten der klinischen Rheumatologie, der Therapie rheumatischer Erkrankungen sowie der rheumatologischen Grundlagenforschung. Umfassende Übersichtsarbeiten zu einem aktuellen Schwerpunktthema sind das Kernstück jeder Ausgabe. Im Mittelpunkt steht dabei gesichertes Wissen zu Diagnostik und Therapie mit hoher Relevanz für die tägliche Arbeit – der Leser erhält konkrete Handlungsempfehlungen. Frei eingereichte Originalien ermöglichen die Präsentation wichtiger klinischer Studien und dienen dem wissenschaftlichen Austausch.
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