Vertebral fractures in a young woman: the impact of hypogonadism, glucocorticoids and chronic disease
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ID: 314818
2026
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Abstract
A premenopausal woman was reviewed for painful vertebral fractures in the context of prednisolone exposure for her newly diagnosed systemic lupus erythematosus. Known clinical risk factors for bone loss included exposure to depot medroxyprogesterone acetate for 12 yr, cigarette smoking, a family history of osteoporosis and ongoing inflammatory arthritis. Initial investigations also identified vitamin D deficiency and low bone mass for age and sex. She was treated with vitamin D and her contraception was changed to a levonorgestrel intrauterine device. In the context of further vertebral fractures confirmed with both MRI and bone scan and having had additional secondary causes of low bone mass excluded, she commenced targeted osteoporosis treatment. We discuss the complexities of managing bone fragility in young adults and the impact of depot medroxyprogesterone acetate, inflammatory disease (systemic lupus erythematosus) and glucocorticoid-induced osteoporosis on younger adults. In this woman, antiresorptive therapy with zoledronic acid was recommended; we also explore the existing evidence-base for antiresorptive and anabolic therapies in younger adults, with a particular focus on glucocorticoid-induced osteoporosis.
| Reference Key |
openalex_W7162191318
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|---|---|
| Authors | Madhuni Herath, Hanh H Nguyen, Frances Milat, Peter R Ebeling |
| Journal | journal of bone and mineral research : the official journal of the american society for bone and mineral research |
| Year | 2026 |
| DOI |
10.1093/jbmr/zjag088
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| URL | |
| Keywords | Keywords not found |
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