BMJ 1995;311:687 (9 September)

Letters

Is indicated after long term treatment with heparin

EDITOR,--There is an important omission from the clinical indications for bone densitometry listed in J E Compston and colleagues' review article1--namely, long term treatment with heparin, which causes osteoporosis.2 The most common indication for long term heparin is thromboprophylaxis in pregnant women. It is our policy to treat women at high risk of thromboembolism (those with a history of recurrent thromboembolism and those with thrombophilia or antiphospholipid antibodies) with subcutaneous heparin throughout pregnancy and the puerperium. In some units even women at lower risk of recurrent thromboembolism (for example, those who have had only a single thromboembolic event) may receive heparin throughout pregnancy.

Part of the problem is that pregnancy itself may cause a reduction in bone density. In a prospective study of bone mineral density in pregnancy Dahlman et al used single photon absorptiometry and found a 5% reduction in trabecular bone (equivalent to two years' postmenopausal loss) . . . [Full text of this article]


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Relevant Article

Fortnightly Review: Bone densitometry in clinical practice
J E Compston, C Cooper, and J A Kanis
BMJ 1995 310: 1507-1510. [Abstract] [Full Text]

This article has been cited by other articles:

  • Barlow, D., Cooper, C., Reeve, J., Reid, D. (1996). Department of Health is fair to patients with osteoporosis. BMJ 312: 297-298 [Full text]  
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