engleski

Secondary Osteoporosis in Patient with Adult Celiac Disease

Bowel diseases are frequently associated with bone loss. We have analyzed a fifty two year old woman who came to the clinic with the ilness history of diarrhea, loss of weight and old fracture of fourth left metacarpal bone. Routine laboratory test indicated malapsorption problems. Results of D-xylosa test, lipid absorption test, endomisial antibodies and jejunal biopsy confirmed the diagnosis of celiac disease. After the specific diet treatment she slowly gained weight, but body mass index (BMI) did not rise more than 20 kg/m2.After she was complaining of back pain, x-ray examination and bone densitometry were done. Low bone mineral density (BMD) values indicated osteoporosis. Biochemical markers of bone resorption confirmed an active resorption phase of bone remodeling. Parathyroid hormone (PTH) was twice the normal values. Bone biopsy and hystomorphometry established the diagnosis of hyperparathyroidism. After three mounths of treatment with biosposphonates (alendronate), vitamin D and calcium supplementation, bone markers were elevated and the patient complained less of back pain. The findings of the present case report suggest that patients with malapsorption syndrome are at high risk for bone loss. Further studies are needed to evaluate the efficacy of specific antiresorptive therapies and clinical utility of biochemical markers of bone turnover in predicting therapeutic response in these patients.

secondary osteoporosis; celiac disease

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