To study the predictive factors for avascular necrosis (AVN) of bone in patients with systemic lupus erythematosus (SLE).
The records of 38 SLE patients who developed clinically apparent AVN during the course of their disease were reviewed.
Information on clinical presentation, corticosteroid usage and autoantibody profiles was obtained, and comparison was made between these patients and 143 consecutive control SLE patients who did not have AVN.
The point prevalence of AVN in our SLE population was 12%. Patients with AVN. when compared with controls, had a significantly higher incidence of neurological disease (39% vs 14% ; P<0.001) and Cushingoid body habitus after steroid treatment (79% vs 53% ; P=0.004).
The highest cumulative prednisolone dose in 1 and 4 months was significantly higher in the AVN group than the controls (1.8 vs 1.1 and 4.5 vs 2.8 g, respectively ; P<0.01 in both) and showed a linear trend with the incidence of AVN (X2 test for trend, P<0.01 in both).
Lupus anticoagulant was associated with AVN (P=0.02, odds ratio 2.88 [1.14 7.28]). Logistic regression analysis revealed that the highest cumulative prednisolone dose administered in 4 months, the maximum and mean daily prednisolone dosage, and the lupus anticoagulant were independent risk factors for AVN.
Corticosteroid remains the major predisposing factor for AVN in SLE. (...)
Mots-clés Pascal : Lupus érythémateux, Disséminé, Complication, Ostéonécrose aseptique, Evolutivité, Homme, Epidémiologie, Prévalence, Facteur risque, Corticostéroïde, Régression logistique, Peau pathologie, Tissu conjonctif pathologie, Maladie système, Maladie autoimmune, Immunopathologie, Système ostéoarticulaire pathologie, Ostéopathie
Mots-clés Pascal anglais : Lupus erythematosus, Disseminated, Complication, Aseptic osteonecrosis, Evolutivity, Human, Epidemiology, Prevalence, Risk factor, Corticosteroid, Logistic regression, Skin disease, Connective tissue disease, Systemic disease, Autoimmune disease, Immunopathology, Diseases of the osteoarticular system, Bone disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0405901
Code Inist : 002B07. Création : 25/01/1999.