High risk of osteonecrosis of the femoral head in autoimmune disease patients showing no immediate increase in hepatic enzyme under steroid therapy.
Aim of the study is to determine the relationship between liver function and the incidence of ONF after steroid therapy in AID patients. The present study investigated 58 AID patients who had received high-dose systemic steroid therapy to determine whether a correlation exists between parameters of hepatic function and steroid-induced ONF at the precise time-point when steroid-induced ONF develops. The patients were divided into two groups on the basis of MRI findings: ONF (n = 31) and non-ONF (n = 27). The ONF group showed no increase in AST, ALT, or LDH within 4 weeks after the commencement of steroid therapy. By contrast, the non-ONF group showed an immediate and significant increase in all of these parameters. In the ONF group, hepatic steatosis and elevated triglyceride levels were also observed. Following 4 weeks of steroid therapy, there were no significant differences in biochemical data between two groups. Patients showing no immediate increase in ALT and AST in response to steroid therapy were at high risk of ONF. These findings provide important insights into the pathogenesis of steroid-induced ONF and may facilitate the development of prevention strategies in patients with AID.
Department of Legal Medicine and Molecular Alcohology, Sapporo Medical University School of Medicine, S-1 W-17, Chuo-Ku, Sapporo 060-8556, Japan.
Shunichiro
S
Okazaki
Satoshi
S
Nagoya
Motohisa
M
Yamamoto
Kenji
K
Tateda
Hiroki
H
Takahashi
Toshihiko
T
Yamashita
Hiroshi
H
Matsumoto
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001327:Autoimmune Diseases / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood / Q000150:complications / Q000209:etiology*; D005234:Fatty Liver / Q000097:blood / Q000139:chemically induced / Q000473:pathology; D005260:Female; D005271:Femur Head Necrosis / Q000097:blood / Q000139:chemically induced* / Q000150:complications; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D015228:Hypertriglyceridemia; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000187:drug effects* / Q000378:metabolism; D008111:Liver Function Tests; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D055953:Microscopic Polyangiitis / Q000097:blood / Q000150:complications / Q000188:drug therapy; D008875:Middle Aged; D008882:Mikulicz' Disease / Q000097:blood / Q000150:complications / Q000188:drug therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D005938:Glucocorticoids; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase