Stress fracture consolidation after the administration of teriparatide in a patient with osteogenesis imperfecta

LAURRETA DE SANTIS, P; AGUILAR GABRIEL; MASTAGLIA SILVINA

Congreso; Tercer Congreso Argentino de Osteología y Metabolismo Mineral; 2021

Osteogenesis imperfecta (OI) is a hereditary connective tissue disease caused by genetic mutations of the genes that codify collagentype 1 (COL1A1 and COL1A2) and associated with bone fragility. Teriparatide (TPTD) [Humanrecombinant PTH 1-34] is an anabolic drug that has become a possible option for the treatment of the OI as well as for delayed fracture healing.Objective: Present a patient with OI type 1 accompanied by a stress fracture due to a severe deformation in the middle third of left femur, which shows evidence of consolidationafter a three-months of administration of TPTD. Case presentation: A 58-year-old woman with diagnosis of Type 1 OI and a significant deformation of lateral shaft bowing of the left femur. On presentation, the patient reported pain n her left thigh; after stumbling while walking inthe street, which was not relieved with NSAIDs administration. An X-Ray was performed dueto pain persistence, showing a stress fracture in the middle third of the left femur. Treatmentwith 20 μg/day of subcutaneous (s.c) TPTD was initiated. After one month of treatment, thepatient showed significant relief of pain, without progression of the fracture by the third monthof application. At this, point the treatment was discontinued for economic issues. Due to thepandemic, a radiographic control was obtained after one year of treatment interruption, withoutshowing a trace of fracture. Conclusion: TPTD has shown to be effective to improve stressfracture consolidation caused by femoral bowing deformation in a patient with OI. Further studiesare required to confirm this result.