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Conclusions: The osteoporosis in BTM has a complex mechanism; both increased bone resorption and decreased formation being involved. Probably the extent of contribution of the two mechanisms varies in each patient. Although the bisphosphonates are the most used treatment for osteoporosis in BTM, our case report suggests that, at least in some patients, decreased bone formation is the predominant mechanism and teriparatidum could be the most appropriate therapy.

Disclosure: This paper is partly supported by the Sectorial Operational Programme Human Resources Development (SOPHRD), financed by the European Social Fund and the Romanian Government under the contract number POSDRU 141531.