EP368 - ECE_3787 - Postpartum osteoporosis as a diagnostic challenge: a case report
Abstract
Postpartum Osteoporosis as a Diagnostic Challenge: A Case Report
Postpartum osteoporosis, also referred to as pregnancy- and lactation-associated osteoporosis (PLO), is an uncommon condition characterized by substantial bone loss and an increased risk of fragility fractures in young women. As back pain is a frequent complaint in the postpartum period, the underlying diagnosis may be overlooked, contributing to delayed recognition of postpartum osteoporosis in clinical practice.
We describe the case of a 33-year-old woman, with a body mass index of 18.9 kg/m2 who presented with acute, severe, non-traumatic back pain occurring six months after delivery. The patient was actively breastfeeding at the time of presentation. She had no prior fractures, chronic illnesses, or exposure to medications known to affect bone metabolism. Pregnancy and delivery were uncomplicated.
Physical examination revealed restricted spinal mobility with localized tenderness. Laboratory evaluation showed normal serum calcium, phosphate, parathyroid hormone, and 25 hydroxyvitamin D levels, with normal renal and thyroid function, excluding secondary causes of osteoporosis. Dual-energy X-ray absorptiometry demonstrated markedly reduced bone mineral density, predominantly at the lumbar spine (Z-score ≤ −2.5). Spinal magnetic resonance imaging revealed vertebral compression fractures.
Based on clinical presentation, imaging findings, prolonged lactation history, and exclusion of secondary etiologies, a…
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