study of avascular necrosis [osteonecrosis] in systemic lupus erythematosus patients and its relation to corticosteroid therapy

ABSTRACT

Avascular necrosis [AVN] of the femoral head has been reported to be one of the major problems during the course of SLE. In a retrospective study of 30 patients with SLE, four [13.3%] were found to have AVN all had been on corticosteroids. Of these, three [75%] had Raynaud's phenomenon, three [75%] took pulse steroid therapy, and three [75%] had thrombocytopenia. None of the patients abused alcohol or had chronic liver disease. A positive correlation was found between hyperelipidaemia as well as the presence of high titre of anticardiolipin antibodies [both IgMand IgG] and the occurence of AVN. Moreover, statistically significant differences were found between patients with and without AVN as regards the total duration of steroid intake, the total cumulative prednisolone dose or its equivalent as well as the daily dose with significantly higher levels in patients with AVN than in those without. So, it is suggested that corticosteroid therapy play the major role in the development of AVN in SLE patients in addition to lipid and haemostatic abnormalities