title: Avascular necrosis in pediatric systemic lupus erythematosus: a brief report and review of the literature.
abstract: Avascular necrosis (AVN) occurs in several chronic illnesses, including systemic lupus erythematosus (SLE), but can also occur in healthy children. There are multiple theories to explain why and how AVN occurs, but an exact mechanism has yet to be unraveled. AVN in the pediatric lupus population is understudied. The Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) trial, provides an excellent venue to conduct an exploratory analysis to assess associations between AVN and demographics, SLE disease activity and vitamin D deficiency. Herein we present a brief report describing our findings, as well as reviewing the literature on AVN in SLE and other entities.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT00065806.
authors.affiliation: Division of Pediatric Infectious Diseases, Rheumatology and Global Health, Department of Pediatrics, Rainbow Babies and Children's Hospital/Case Medical Center, Cleveland, OH, USA. reut.gurion@uhhospitals.org.
authors.forename: Reut
authors.initials: R
authors.lastname: Gurion
authors.affiliation: Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA. vin.tangpricha@emory.edu.|Atlanta VA Medical Center, Decatur, Georgia, USA. vin.tangpricha@emory.edu.
authors.forename: Vin
authors.initials: V
authors.lastname: Tangpricha
authors.affiliation: Duke Clinical Research Institute, Durham, North Carolina, USA. eric.yow@duke.edu.
authors.forename: Eric
authors.initials: E
authors.lastname: Yow
authors.affiliation: Division of Pediatric Rheumatology, Duke University Medical Center, Durham, NC, 27710, USA. laura.schanberg@duke.edu.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Schanberg
authors.affiliation: Division of Pediatric Infectious Diseases, Rheumatology and Global Health, Department of Pediatrics, Rainbow Babies and Children's Hospital/Case Medical Center, Cleveland, OH, USA. grace.mccomsey@case.edu.|Division of Medicine, University Hospital Case Medical Center, 1100 Euclid Avenue, Cleveland, OH, 44106, USA. grace.mccomsey@case.edu.
authors.forename: Grace A
authors.initials: GA
authors.lastname: McComsey
authors.affiliation: Division of Pediatric Infectious Diseases, Rheumatology and Global Health, Department of Pediatrics, Rainbow Babies and Children's Hospital/Case Medical Center, Cleveland, OH, USA. angela.robinson@uhhospitals.org.
authors.forename: Angela Byun
authors.initials: AB
authors.lastname: Robinson
mesh_terms: D064987:Cell- and Tissue-Based Therapy; D002648:Child; D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000503:physiopathology*; D009985:Orthopedics; D010020:Osteonecrosis / Q000209:etiology* / Q000503:physiopathology* / Q000628:therapy; D012720:Severity of Illness Index; D014665:Vasodilator Agents / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000503:physiopathology
chemical_list: D004164:Diphosphonates; D014665:Vasodilator Agents