Journal List > Endocrinol Metab > v.27(4) > 1085983

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Kim, Yang, Choi, Yoo, Seo, Choi, Kim, Kim, Baik, Choi, and Choi: A Case of Multiple Osteoporotic Compression Fractures in Young Man with Budd-Chiari Syndrome
Case Report
Endocrinology and Metabolism

Endocrinology and Metabolism 2012; 27(4): 334-339.

Published online: 20 December 2012

DOI: https://doi.org/10.3803/EnM.2012.27.4.334

A Case of Multiple Osteoporotic Compression Fractures in Young Man with Budd-Chiari Syndrome

Sun Hwa Kim, Tae Un Yang, Byeong Kwang Choi, Hye Jin Yoo, Ji A Seo, Kyung Mook Choi, Nan Hee Kim, Sin Gon Kim, Sei Hyun Baik, Dong Seop Choi, Hae Yoon Choi

Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

Corresponding author: Hae Yoon Choi. Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 152-703, Korea. Tel: +82-2-2626-3046, Fax: +82-2-2626-1096, kahlua99@hanmail.net

Received 23 July 2012       Accepted 18 September 2012

Copyright © 2012 Korean Endocrine Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Osteoporosis in young men is extremely rare. In this report, we demonstrate a rare case of multiple vertebral fractures discovered in a young man with Budd-Chiari syndrome without prior history of trauma. A 29-year-old man was diagnosed as Budd-Chiari syndrome 12 years ago and underwent a mesocaval shunt to relieve the hepatic vein obstruction and was on warfarin therapy. He suffered from low back pain and it was not relieved by analgesics. A T-L spine X-ray revealed multiple compression fractures and the z-score at lumbar spine was -3.7 which is below the expected range for that age. The patient was treated with calcium, vitamin D and bisphosphonate, and showed clinical improvement. This case highlights the importance of the investigation for secondary osteoporosis in young adults with an underlying disease that alters bone metabolism.

Keywords: Budd-Chiari syndrome, Liver cirrhosis, Osteoporosis

Figures and Tables

Fig. 1
The simple X-ray images of the patient. (A) Abdominal plain film shows mild scoliosis and stent of mesocaval shunt. (B) Lateral plain film shows multiple compression fractures at T7 through L4.
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Fig. 2
Computed tomography image of T-L spine shows multiple compression fractures at T7 to L5 spine.
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Fig. 3
Bone scan shows hot uptake at right 4th, 10th ribs and left 2nd, 5th, and 8th ribs. Diffuse hot uptake at T7 to L5 vertebrae is also noted.
enm-27-334-g003
Fig. 4
Bone densitometry demonstrates low bone mineral density at lumbar spine and right femur.
enm-27-334-g004

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