title: Bone microarchitecture deteriorations and a fragility fracture in a patient with beta and alpha heterozygous thalassemia: a case report.
abstract: To date there are few studies that have investigated bone mineral density (BMD) and markers of bone metabolism in patients with thalassemia minor form. None of the previous trials presented bone structure analysis in the patient populations. We present the case of a 24-year-old Turkish woman with heterozygous beta and alpha thalassemia who sustained a low-trauma fracture of the inferior pubic ramus. Despite normal markers of bone metabolism, the dual X‑ray absorptiometry (DXA) showed decreased areal bone mineral density. Furthermore, severely reduced bone structure parameters and reduced volumetric bone mineral density was assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT). Due to these diagnostic findings at time of peak bone mass, an osteoanabolic therapy with teriparatide for 24 months was initiated. The findings concerning BMD and bone structure in this patient can be seen as caused by the beta and alpha thalassemia.
authors.affiliation: Medical Department II, St. Vincent Hospital Vienna, Academic Teaching Hospital of the Medical University Vienna, Stumpergasse 13, 1060, Vienna, Austria.
authors.forename: Xaver
authors.initials: X
authors.lastname: Feichtinger
authors.affiliation: Medical Department II, St. Vincent Hospital Vienna, Academic Teaching Hospital of the Medical University Vienna, Stumpergasse 13, 1060, Vienna, Austria.
authors.forename: Roland
authors.initials: R
authors.lastname: Kocijan
authors.affiliation: Medical Department II, St. Vincent Hospital Vienna, Academic Teaching Hospital of the Medical University Vienna, Stumpergasse 13, 1060, Vienna, Austria.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Resch
authors.affiliation: Medical Department II, St. Vincent Hospital Vienna, Academic Teaching Hospital of the Medical University Vienna, Stumpergasse 13, 1060, Vienna, Austria. christian.muschitz@bhs.at.
authors.forename: Christian
authors.initials: C
authors.lastname: Muschitz
mesh_terms: D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005260:Female; D005598:Fractures, Spontaneous / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D010014:Osteolysis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D019379:Teriparatide / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult; D017085:alpha-Thalassemia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D017086:beta-Thalassemia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D050071:Bone Density Conservation Agents; D019379:Teriparatide
keywords: Bone microarchitecture; HR-pQCT; Thalassemia