Use of Alendronate in treatment of secondary osteoporosis from hypopituitarism: a case report

D. Maugeri, M.R. Bonanno, M.S. Russo, S. Speciale, A. Santangelo, M.P. Curasì, P. Panebianco

Department of Senescent, Urological and Neurological Sciences, University of Catania (Italy)

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• Rheumatology

Abstract. – The authors report a case of hypogonadotropic and hypothyrotropic partial hypopituitarism, being treated for over sixteen years with a substitution therapy consisting of estroprogestogenal hormones and L-thyroxine, presenting severe secondary osteoporosis, detected by densitometric examination (DEXA) of the medial and ultradistal sites of the non dominant radius. The patient was treated with alendronate (10 mg/die) for two years, in addition to the estroprogestogen therapy, resulting in a significant recovery of bone mass, equal to 16% compared to initial values, reaching near normal bone density values. On analysing the mechanisms of action of the bisphosphonates, the estrogens and the L-thyroxines, the authors suggest a synergic mechanism between the estrogen and the alendronate, which act on the bone turn-over at different times. Also, the alendronate would seem to antagonise the osteopenia of L-thyroxine, though this mechanism is still unknown.

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