caa a22 4500 605520801 CHVBK 20210128100737.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00223-015-0028-z doi (NATIONALLICENCE)springer-10.1007/s00223-015-0028-z Pregnancy and Lactation-Associated Osteoporosis: Bone Histomorphometric Analysis and Response to Treatment with Zoledronic Acid [Elektronische Daten] [Felipe Grizzo, Janaina da Silva Martins, Marcelo Pinheiro, Vanda Jorgetti, Maria Carvalho, Sandra Pelloso] Pregnancy and lactation-associated osteoporosis (PAO) is a rare condition with little known pathophysiology. Most cases are diagnosed in the third trimester of pregnancy or in the first weeks postpartum, particularly in first pregnancies. Vertebral fractures are most commonly observed and characterised by prolonged severe pain, functional limitations and a loss of height. Measurements of bone mineral density and biochemical markers of bone remodelling are the clinical methods most commonly used for the management of these patients. However, a bone biopsy with histomorphometric analysis has been considered to be the gold-standard. Few studies have evaluated the histomorphometry in patients with this clinical condition and none of them performed the procedure at the beginning of the clinical assessment. In this study, we report a case of PAO in a 31-year-old postpartum patient who had undergone a twin pregnancy. We describe the clinical, laboratory tests and imaging features. Bone histomorphometry showed a high resorption rate and excellent evolution after 1year of treatment with intravenous zoledronic acid. Our data suggest that osteoclastogenesis plays a central role in the pathophysiological processes of this disease. Springer Science+Business Media New York, 2015 Osteoporosis nationallicence Pregnancy nationallicence Lactation nationallicence Bone histomorphometry nationallicence Bone biopsy nationallicence Bisphosphonates nationallicence Grizzo Felipe Health Sciences Centre, UEM, Avenida Dr. Luiz Teixeira Mendes, 1888, Zona 05, CEP 87015-000, Maringá, PR, Brazil aut da Silva Martins Janaina Department of Medicine, UEM, Maringá, PR, Brazil aut Pinheiro Marcelo Rheumatology, UNIFESP, São Paulo, SP, Brazil aut Jorgetti Vanda Nephrology, USP, São Paulo, SP, Brazil aut Carvalho Maria Department of Medicine, UEM, Maringá, PR, Brazil aut Pelloso Sandra Nursing Department, UEM, Maringá, PR, Brazil aut Calcified Tissue International Springer US; http://www.springer-ny.com 97/4(2015-10-01), 421-425 0171-967X 97:4<421 2015 97 223 https://doi.org/10.1007/s00223-015-0028-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00223-015-0028-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Grizzo Felipe Health Sciences Centre, UEM, Avenida Dr. Luiz Teixeira Mendes, 1888, Zona 05, CEP 87015-000, Maringá, PR, Brazil aut NATIONALLICENCE 700 1- da Silva Martins Janaina Department of Medicine, UEM, Maringá, PR, Brazil aut NATIONALLICENCE 700 1- Pinheiro Marcelo Rheumatology, UNIFESP, São Paulo, SP, Brazil aut NATIONALLICENCE 700 1- Jorgetti Vanda Nephrology, USP, São Paulo, SP, Brazil aut NATIONALLICENCE 700 1- Carvalho Maria Department of Medicine, UEM, Maringá, PR, Brazil aut NATIONALLICENCE 700 1- Pelloso Sandra Nursing Department, UEM, Maringá, PR, Brazil aut NATIONALLICENCE 773 0- Calcified Tissue International Springer US; http://www.springer-ny.com 97/4(2015-10-01), 421-425 0171-967X 97:4<421 2015 97 223