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Osteogenesis Imperfecta Presenting with Fractures in Pregnancy or Lactation Period: Report of Three Cases

  • Seher Tanrıkulu
  • Nurdan Gül
  • Gülşah Yenidünya Yalın
  • Sakin Tekin
  • Özlem Soyluk Selçukbiricik
  • Ayşe Kubat Üzüm
  • Ferihan Aral
  • Refik Tanakol

J Clin Res Pediatr Endocrinol 2015;7(2):82-82

Modifications of bone and mineral metabolism in pregnancy and lactation period can worsen the clinically silent osteoporosis and may cause bone fractures. We report three cases of osteogenesis imperfecta (OI) that presented during pregnancy and lactation period.

Case-1:

A 32-year-old woman presented with low back and left hip pain in lactation period. She has had blue sclera and multiple recurrent bone fractures. Patient was treated with vitamin D, calcium, and pamidronate 90 mg. On follow-up, she was completely free of fractures during the therapy.

Case-2:

A 26-year-old woman presented with gradually increasing low back pain after delivery. Family history revealed that her mother and sister have had multiple recurrent bone fractures and her daughter had blue sclera. Neurological examination revealed moderate hearing loss. Radiologic studies revealed L1 and L2 compression fracture. She was treated with vitamin D, calcium, and parenteral bisphosphonate for a period of 6 years. The patient was completely free of bone fractures.

Case 3:

A 29-year-old woman who had a history of OI in her family presented with right first metatarsal fracture at 18th week of her pregnancy. Past medical history revealed that she had recurrent right ankle fractures. After vitamin D was given and calcium replacement was initiated, her lactation was stopped. Bone turnover markers were elevated. L4 Z-score on DXA was -4.3. The patient was treated with pamidronate 90 mg. No bone fractures occurred during follow-up. Although OI is a rare disorder, it might be the reason behind the fractures presenting during pregnancy or lactation period, and gestational and lactation osteoporosis may be concurrent with occult forms of OI.

Keywords: Osteogenesis imperfecta, pregnancy, lactation period, osteoporosis, fracture