Risk factors for avascular bone necrosis in patients with systemic lupus erythematosus.
The objective was to investigate the predictive factors for avascular necrosis (AVN) of bone in patients with systemic lupus erythematosus (SLE). The records of 868 patients with SLE from four centers were reviewed retrospectively. Forty-nine patients with AVN were identified. A total of 154 patients with SLE who did not have clinically apparent AVN during the follow-up were evaluated as a control group. The demographic, clinical, laboratory and management characteristics of these two groups of patients were recorded according to predefined protocol and compared. The prevalence of AVN was detected 6% in our SLE population. The highest dose corticosteroid administered within 4 months and total cumulative prednisolone dose were significantly higher in the SLE patients with AVN. The use of cytotoxic agent significantly higher proportion of patients with AVN. AVN tends to develop more frequently in male gender and younger patients. Oral ulcer, pleuritis, Raynaud's phenomenon, cutaneous vasculitis, lymphadenopathy, autoimmune thyroiditis, peripheral neuropathy and Sjögren's syndrome were higher incidence in SLE patients with AVN. The bilateral femoral heads were the commonest site of involvement of AVN in our patients with SLE.
Sayarlioglu
Mehmet
M
Department of Rheumatology, Faculty of Medicine, Kahramanmaraş Sutcu Imam University, Kahramanmaraş, Turkey. sayarli@yahoo.com
Yuzbasioglu
Nergis
N
Inanc
Murat
M
Kamali
Sevil
S
Cefle
Ayse
A
Karaman
Ozcan
O
Onat
Ahmet Mesut
AM
Avan
Rustem
R
Cetin
Gozde Yildirm
GY
Gul
Ahmet
A
Ocal
Lale
L
Aral
Orhan
O
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D005271:Femur Head Necrosis / Q000453:epidemiology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D010020:Osteonecrosis / Q000453:epidemiology*; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D011239:Prednisolone