Risk factors for avascular bone necrosis in systemic lupus erythematosus

Rheumatology ◽  
1998 ◽  
Vol 37 (8) ◽  
pp. 895-900 ◽  
Author(s):  
C. C. Mok ◽  
C. S. Lau ◽  
R. W. Wong
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Bone Necrosis ◽  
Avascular Bone Necrosis

Risk factors for avascular bone necrosis in patients with systemic lupus erythematosus

2010 ◽  
Vol 32 (1) ◽  
pp. 177-182 ◽  
Author(s):  
Mehmet Sayarlioglu ◽  
Nergis Yuzbasioglu ◽  
Murat Inanc ◽  
Sevil Kamali ◽  
Ayse Cefle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Bone Necrosis ◽  
Avascular Bone Necrosis

Time trend and risk factors of avascular bone necrosis in patients with systemic lupus erythematosus

Lupus ◽  
2016 ◽  
Vol 26 (7) ◽  
pp. 715-722 ◽  
Author(s):  
Sau Mei Tse ◽  
Chi Chiu Mok
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Logistic Regression ◽  
Cumulative Dose ◽  
Lupus Erythematosus ◽  
Time Trend ◽  
High Dose ◽  
Systemic Lupus ◽  
Bone Necrosis ◽  
Avascular Bone Necrosis

Objectives The objective of this paper is to study the time trend and risk factors of avascular bone necrosis (AVN) in patients with systemic lupus erythematosus (SLE). Methods Between 1999 and 2014, patients who fulfilled the ACR criteria for SLE and developed symptomatic AVN were identified from our cohort database and compared with those without AVN, matched for age, sex and SLE duration. The standardized incidence ratios (SIRs) of AVN in different SLE age groups were calculated from data derived from our hospital registry and population census. Risk factors for AVN were studied by logistic regression, adjusted by a propensity score for ever use of high-dose glucocorticoids (GCs). Results Fifty-five SLE patients with AVN and 220 SLE patients without AVN were studied. There were 104 AVN sites involved, with the hips being most commonly affected (82%). The point prevalence of AVN in our SLE cohort was 7.4%. The SIRs of AVN in our SLE patients were 131 (86.6–199; p < 0.001) and 56.0 (34.3–91.4; p < 0.001), respectively, in the periods 1995–2004 and 2005–2014. In both decades, the age-stratified SIR was highest in the youngest age group (<19 years). AVN patients were more likely to be treated with GCs and had received a significantly higher cumulative dose of prednisolone since SLE diagnosis (16.5 vs 10.7 grams; p = 0.001). The SLE damage score (excluding AVN) was also significantly higher in AVN than non-AVN patients (2.5 vs 0.4; p < 0.001). Logistic regression revealed that preceding septic arthritis of the involved joint (odds ratio (OR) 17.7 (1.5–205); p = 0.02), cushingoid body habitus (OR 2.4 (1.1–5.2); p = 0.04), LDL cholesterol level (OR 1.4 (1.0–1.9); p = 0.04), maximum daily dose of prednisolone (OR 6.4 (1.2–33.3); p = 0.03) and cumulative dose of prednisolone received in the first six months of the first lupus flare (OR 1.3 (1.0–1.8); p = 0.046) were independently associated with AVN. Conclusions AVN is prevalent in SLE, particularly in younger patients. The use of GCs remains the strongest independent risk factor. A trend of reduction in the SIR of AVN in our SLE patients is observed over the past two decades.

scholarly journals BEYOND CORTICOSTEROIDS: RISK FACTORS FOR AVASCULAR BONE NECROSIS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2019 ◽  
Author(s):  
LARISSA DE BARROS OLIVEIRA ◽  
ADIB CHICRE MANSUR NETO ◽  
MAURO GOLDFARB ◽  
MARILENA LEAL MESQUITA SILVESTRE FERNANDES ◽  
ADRIANA DANOWSKI
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Bone Necrosis ◽  
Avascular Bone Necrosis

scholarly journals Protesa obturator definitif resin akrilik pada pasien systemic lupus erythematosus (SLE) pasca maksilektomi

2020 ◽  
Vol 32 (2) ◽  
pp. 63
Author(s):  
Pramudya Aditama ◽  
Erwan Sugiatno ◽  
Murti Indrastuti ◽  
Endang Wahyuningtyas
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Wire Mesh ◽  
Systemic Lupus ◽  
Bone Necrosis ◽  
Avascular Bone Necrosis ◽  
Titanium Wire

ABSTRAKPendahuluan: Systemic lupus erythematosus (SLE) merupakan inflamasi kronis yang dapat melibatkan sistem saraf, membran mukosa, dan organ lain dalam tubuh. Avascular bone necrosis (AVN) merupakan gejala yang muncul pada penderita SLE. Maksilektomi dilakukan pada tulang maksila yang mengalami AVN. Penutupan celah pasca maksilektomi tersebut dilakukan dengan cara  menggunakan protesa maksilofasial intraoral yaitu obturator. Tujuan laporan kasus ini mengkaji rehabilitasi prostetik menggunakan protesa obturator definitif resin akrilik pada penderita SLE pasca maksilektomi. Laporan kasus: Seorang wanita berusia 21 tahun datang ke Poli Gigi dan Mulut RSUP Dr. Sardjito dengan keluhan bau mulut, hilangnya gusi pada langit-langit, dan kegoyahan gigi rahang atas. Pasien didiagnosis SLE sejak lebih dari 1 tahun yang lalu. Pada pemeriksaan intraoral, selain lesi pada mukosa palatum, ditemukan juga nekrosis pada tulang palatum, kehilangan gigi 14, 15, 16, dan 25, serta kegoyahan derajat 3 pada seluruh gigi rahang atas yang tersisa. Pasien dirawat dengan obat Myfortic (2 x 180 mg/hari) dan Fluconazole (1x150 mg/hari) kemudian dirujuk ke Poli Bedah Mulut untuk dilakukan maksilektomi, dilanjutkan dengan pembuatan protesa obturator oleh tim prostodonti. Pasien dibuatkan obturator pasca bedah untuk menutup celah palatum pasca maksilektomi. Pencetakan menggunakan bahan hydrocolloid irreversible sebelum operasi untuk pembuatan obturator pasca bedah. Insersi obturator menunjukkan celah palatum tertutup rapat oleh plat akrilik. Retensi didapatkan menggunakan kawat stainless pada titanium wire mesh pengganti tulang maksila. Tidak ada keluhan saat kontrol, penelanan baik. Tiga bulan pasca pemakaian obturator pasca bedah dilakukan pemasangan obturator definitif resin akrilik rahang atas. Pemeriksaan klinis menunjukkan suara sengau berkurang, estetis, dan pengunyahan baik. Simpulan: Protesa obturator definitif resin akrilik pada pasien SLE pasca maksilektomi dapat mengembalikan fungsi estetik, mengurangi suara sengau (mengembalikan fungsi bicara), mengembalikan fungsi penelanan, dan pengunyahan.

Risk Factors Associated with Systemic Lupus Erythematosus in Oman

2020 ◽  
Vol 03 (04) ◽  
Author(s):  
Asma Al-Kindi ◽  
Batool Hassan ◽  
Aliaa Al-Moqbali ◽  
Aliya Alansari
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Factors Associated

scholarly journals Predictors of renal damage in systemic lupus erythematous patients: data from a multiethnic, multinational Latin American lupus cohort (GLADEL)

RMD Open ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e001299
Author(s):  
Cristina Reátegui-Sokolova ◽  
Manuel F Ugarte-Gil ◽  
Guillermina B Harvey ◽  
Daniel Wojdyla ◽  
Guillermo J Pons-Estel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Latin American ◽  
Lupus Erythematosus ◽  
Renal Damage ◽  
Cox Regression ◽  
Damage Index ◽  
Early Response ◽  
Male Gender ◽  
Systemic Lupus

AimA decrease in proteinuria has been considered protective from renal damage in lupus nephritis (LN), but a cut-off point has yet to be established. The aim of this study was to identify the predictors of renal damage in patients with LN and to determine the best cut-off point for a decrease in proteinuria.MethodsWe included patients with LN defined clinically or histologically. Possible predictors of renal damage at the time of LN diagnosis were examined: proteinuria, low complement, anti-double-stranded DNA antibodies, red cell casts, creatinine level, hypertension, renal activity (assessed by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)), prednisone dose, immunosuppressive drugs and antimalarial use. Sociodemographic variables were included at baseline. Proteinuria was assessed at baseline and at 12 months, to determine if early response (proteinuria <0.8 g/day within 12 months since LN diagnosis) is protective of renal damage occurrence. Renal damage was defined as an increase of one or more points in the renal domain of The Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI). Cox regression models using a backward selection method were performed.ResultsFive hundred and two patients with systemic lupus erythematosus patients were included; 120 patients (23.9%) accrued renal damage during their follow-up. Early response to treatment (HR=0.58), antimalarial use (HR=0.54) and a high SES (HR=0.25) were protective of renal damage occurrence, whereas male gender (HR=1.83), hypertension (HR=1.86) and the renal component of the SLEDAI (HR=2.02) were risk factors for its occurrence.ConclusionsEarly response, antimalarial use and high SES were protective of renal damage, while male gender, hypertension and higher renal activity were risk factors for its occurrence in patients with LN.

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