| Sub-title | |
| Authors | P J Cassar K Cassar F Camilleri J S DeGaetano |
| Abstract | Osteoporosis is defined as a bone mineral density of less than 2.5 standard deviations below the mean for young adult white women. Dual x-ray absorptiometry (DEXA) is widely used to measure bone density. However, it does not help in identifying the cause of the decreased bone mineral density. The majority of men and pre-menopausal women as well as onefifth of post-menopausal women will have an underlying cause for their osteoporosis. In such cases it is important that treatment is directed at the underlying cause. Coeliac disease is a gluten-sensitive enteropathy and is an established cause of osteoporosis. It is increasingly being diagnosed in asymptomatic patients. We present three cases of postmenopausal women who were referred to our unit with severe osteoporosis. One patient had been treated with oral corticosteroids and had an early menopause. The second patient had an early menopause and a mild anaemia. The third patient had already been treated with HRT, 1?calcidol and oral bisphosphonates but remained severely osteoporotic. All patients had positive anti-endomysial antibodies and duodenal biopsy confirmed the presence of coeliac disease in all three patients. They were instructed to follow a gluten-free diet and were treated with intravenous pamidronate, calcium and vitamin D. These cases demonstrate the importance and necessity of a careful evaluation of all patients referred for the management of osteoporosis as otherwise underlying causes may be missed. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 15 Issue 1-2/suppl. 2003 |
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| Key words | case report, coeliac disease, osteoporosis |