title: Treatment of postmenopausal osteoporosis in a patient with celiac disease.
abstract: BACKGROUND
  A 62-year-old postmenopausal woman with a family history of breast cancer, mild gastroesophageal reflux disease, iron-deficient anemia and declining BMD was seen in a specialist center for the evaluation and management of osteoporosis.
  
  
  METHODS
  Analysis of tissue transglutaminase IgA, endoscopic biopsy, serial BMD scans, FRAX calculation of osteoporotic fracture risk, Gail model calculation of breast cancer risk, assessment of blood vitamin D concentration and secondary evaluation for osteoporosis.
  
  
  METHODS
  Osteoporosis, persistent after 12 years of hormone replacement therapy, and celiac disease.
  
  
  RESULTS
  The patient was initially treated for bone loss with postmenopausal hormone replacement therapy. DXA analyses showed a continued decline in BMD despite adequate replacement of calcium and vitamin D levels and withdrawal of gluten from the patient's diet. An oral bisphosphonate was recommended with plans to reassess BMD after 1 year.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Midlife Health, University of Virginia Health System, 2955 Ivy Road, Suite 104, PO Box 801104, Charlottesville, VA 22908, USA. jvp9u@virginia.edu
authors.forename: JoAnn V
authors.initials: JV
authors.lastname: Pinkerton
authors.forename: Alan C
authors.initials: AC
authors.lastname: Dalkin
authors.forename: Sheila E
authors.initials: SE
authors.lastname: Crowe
authors.forename: Barbara B
authors.initials: BB
authors.lastname: Wilson
authors.forename: Edward B
authors.initials: EB
authors.lastname: Stelow
mesh_terms: D015519:Bone Density / Q000187:drug effects; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis*; D004164:Diphosphonates / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D004164:Diphosphonates