scholarly journals Greater trochanteric bone flap grafting with vascular pedicles for the treatment of femoral head osteonecrosis in patients with systemic lupus erythematosus: A retrospective study

2020 ◽  
Author(s):  
Qiang Yang ◽  
Jixue Zhou ◽  
Lei Li ◽  
Zhaopeng Guo ◽  
Xiaolei Tian
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Femoral Head ◽  
Lupus Erythematosus ◽  
Bone Flap ◽  
Systemic Lupus ◽  
Femoral Head Osteonecrosis ◽  
Replacement Procedure ◽  
The Mean

Abstract Background: Osteonecrosis of the femoral head is a complication of systemic lupus erythematosus,that affect the patient's quality of life seriously.This article reviewed the radiographs of osteonecrosis of the femoral head in patients with systemic lupus erythematosus and assessed the effect of using the greater trochanteric bone flap grafting with vascular pedicles.Methods: We retrospectively reviewed 17 patients (26 hips) with systemic lupus erythematosus who underwent the greater trochanteric bone flap grafting with vascular pedicles for the treatment of osteonecrosis of the femoral head. According to Ficat and Arlet classification, 16 hips were in stage II; 10 hips were in stage III. All patients were followed up for a mean of 32 months (ranging 12~48 months) and were assessed clinically and radiologically according to Harris scoring.Results: No hips were treated with total hip arthroplasty in the follow-up. The mean HHS was improved from preoperative 69.1 points (ranging 52–83 points) to postoperative 89.4 points (ranging 56–100 points). At the latest follow-up, of 26 hips, radiographically 21 hips (80.77%) were improved, 3 hips (11.54%) were unchanged and just 2 hips (7.69%) were worse.Conclusion: The greater trochanteric bone flap grafting with vascular pedicles was successful in maintaining joint function and in delaying the need for joint replacement procedure.

Young systemic lupus erythematosus patients with no hearing involvement: 10-year follow up

2012 ◽  
Vol 127 (1) ◽  
pp. 38-42 ◽  
Author(s):  
J R García-Berrocal ◽  
B De Diego ◽  
A Roldán-Fidalgo ◽  
M Yebra-Bango ◽  
I Millán ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Hearing Loss ◽  
Lupus Erythematosus ◽  
Normal Hearing ◽  
Systemic Lupus ◽  
Progressive Hearing Loss ◽  
The Mean ◽  
One Year ◽  
And Control

AbstractObjective:To evaluate patients with systemic lupus erythematosus and normal hearing over 10 years, compared with healthy controls.Methods:Thirty patients diagnosed with systemic lupus erythematosus were evaluated in a prospective, descriptive study. Eight patients fulfilled the inclusion criteria, i.e. normal otoscopy, normal hearing, normal imaging and disease duration of less than one year. Eleven healthy companions of ENT patients were recruited as controls.Results:At study commencement, the mean patient age was 32.75 years (range, 15–49 years) and there were no statistically significant audiometric differences between patients and controls. No statistically significant audiometric changes were found either within or between the patient and control groups at 10-year follow up.Conclusion:These results supply no evidence for progressive hearing loss in systemic lupus erythematosus patients with no hearing involvement at study commencement. Therefore, we recommend audiometric tests only for systemic lupus erythematosus patients complaining of hearing loss, or for other clinical purposes. It is conceivable that asymptomatic hearing loss could be observed over a more extended follow-up period (i.e. more than 10 years).

scholarly journals Study of Anti-Müllerian Hormone and Its Relation to the Subsequent Probability of Pregnancy in 112 Patients With Systemic Lupus Erythematosus, Exposed or Not to Cyclophosphamide

2013 ◽  
Vol 98 (9) ◽  
pp. 3785-3792 ◽  
Author(s):  
Nathalie Morel ◽  
Anne Bachelot ◽  
Zeina Chakhtoura ◽  
Pascale Ghillani-Dalbin ◽  
Zahir Amoura ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Univariate Analysis ◽  
Serum Levels ◽  
Subsequent Pregnancy ◽  
Systemic Lupus ◽  
Risk Of Failure ◽  
The Mean ◽  
Extrarenal Involvement

Context: Cyclophosphamide is used for renal and major extrarenal involvement in systemic lupus erythematosus (SLE) and is associated with a risk of premature ovarian failure. There are no data available about the relation between anti-Müllerian hormone (AMH) serum levels and the probability of subsequent pregnancy in SLE patients. Objective: We analyzed AMH levels and the probability of pregnancy in SLE women exposed to cyclophosphamide. Design and Setting: We conducted a matched cohort study in referral centers for SLE. Patients: Fifty-six cyclophosphamide-exposed SLE women younger than 40 years of age and 56 control SLE women matched for age within 6 months participated in the study. Main Outcome Measures: AMH was measured in samples from the PLUS study (ClinicalTrials.gov no. NCT00413361). All patients were interviewed in May 2012 regarding their obstetric status. Results: The mean age ± SD of the 112 patients was 31.6 ± 5.8 years. The mean AMH level was low (1.21 ± 1.01 ng/mL) and was significantly lower in patients exposed to cyclophosphamide (P = .03) and in patients older than 30 years (P = .02). During a median follow-up (interval between sampling and the interview) period of 4.2 (range, 2.5–4.8) years, 38 patients sought to become pregnant, and 32 (84.2%) succeeded. In the univariate analysis, the risk of failure was associated with cumulative cyclophosphamide dose (P = .007) and older age (P = .02), but not with AMH. Conclusion: We confirmed that AMH levels are low in SLE patients and decrease significantly with age and cyclophosphamide exposure. Nonetheless, the risk of failure to conceive was low and was predicted by cyclophosphamide exposure and age, but not by AMH levels.

scholarly journals SYSTEMIC LUPUS ERYTHEMATOSUS: CLINICAL RECOMMENDATIONS. PART 2

2018 ◽  
Vol 17 (2) ◽  
pp. 110-125
Author(s):  
Ekaterina I. Alexeeva ◽  
Tatiana M. Dvoryakovskaya ◽  
Irina P. Nikishina ◽  
Rina V. Denisova ◽  
Nadezhda S. Podchernyaeva ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Medical Care ◽  
Lupus Erythematosus ◽  
Genetically Engineered ◽  
Systemic Lupus ◽  
Clinical Recommendations ◽  
Follow Up Care ◽  
Quality Of Medical Care

The article presents modern ideas about the treatment of systemic lupus erythematosus (SLE). The details of the management of patients with SLE during immunosuppressive and genetically engineered therapy is given. The article also reflects the aspects of rehabilitation, prevention of exacerbations, and follow-up care of children with SLE. The criteria for assessing the quality of medical care for children with SLE are presented. The detailed information on systemic lupus erythematosus for patients with SLE and their parents is outlined specifically.

scholarly journals Core Decompression and Biological Treatment in Osteonecrosis of the Hip due to Systemic Lupus Erythematosus, 8-year Follow-up: A Case Report

2021 ◽  
Vol 9 (C) ◽  
pp. 74-79
Author(s):  
Sholahuddin Rhatomy ◽  
Ismail Hadisoebroto Dilogo
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Femoral Head ◽  
Lupus Erythematosus ◽  
Biological Treatment ◽  
Core Decompression ◽  
Treatment Result ◽  
Harris Hip Score ◽  
Systemic Lupus

BACKGROUND: Osteonecrosis most commonly affects the femoral head, especially in middle-aged adults. It can be caused by trauma, chronic inflammation, or infection. It leads to collapse of the entire femoral head and culminates with total hip replacement. CASE REPORT: A 29-year-old female with systemic lupus erythematosus (SLE) had a chief complaint of bilateral hip pain. She was diagnosed with early osteonecrosis of the femoral head (FICAT stage II) using magnetic resonance imaging and core decompression surgery was performed using three small diameter (4 mm) drillings and added biological treatment. She was evaluated with a visual analog scale (VAS), Harris hip score (HHS), and plain radiography in the pre-operative stage and post-operative follow-up. RESULTS: Functional outcome at 8-year follow-up showed improvement with significantly decreased VAS (pre-operative: 5, post-operative: 0), significant improvement of HHS from 52.725 points (poor) pre-operative to 92.025 points (excellent) post-operative, and subsided femoral head lesion. CONCLUSIONS: Surgical decompression and biological treatment result in decreased intraosseous pressure and enhanced osteogenesis. It can restrict the SLE disease progression and limit the number of cell death.

Age at diagnosis and health-related quality of life are associated with fatigue in systemic lupus erythematosus patients: Data from the Almenara Lupus Cohort

Lupus ◽  
2020 ◽  
Vol 29 (12) ◽  
pp. 1644-1649
Author(s):  
Claudia Elera-Fitzcarrald ◽  
Cristina Reátegui-Sokolova ◽  
Rocío V Gamboa-Cárdenas ◽  
Mariela Medina ◽  
Francisco Zevallos ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Emotional Health ◽  
Age At Diagnosis ◽  
Systemic Lupus ◽  
Related Quality ◽  
Health Related ◽  
Multivariable Analyses ◽  
The Mean

Objective To define the factors associated with fatigue in Mestizo patients with Systemic Lupus Erythematosus (SLE). Methods This is a cross-sectional study of SLE patients from a single center cohort. Visits were performed every six months. For these analyses, the first visit between October 2017 and December 2018 was included. Demographic and clinical characteristics as well as treatment were recorded at every visit. Fatigue was ascertained with the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-FT), Health-Related Quality of Life (HRQoL) with the LupusQoL, disease activity with the Systemic Lupus Erythematosus Disease Activity Index –2 K (SLEDAI-2K), and damage with the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology damage index (SDI). Prednisone use was recorded as current daily dose. Immunosuppressive drugs and antimalarial use were recorded as current, past or never. Univariable and multivariable analyses were performed using linear regression models. For the multivariable analyses, model selection followed a backward elimination procedure. Results Two hundred and twenty-six patients were evaluated. The mean (SD) age at diagnosis was 35.6 (13.1) years, 211 (93.4%) were female; and disease duration was 11.0 (7.3) years. The mean SLEDAI and SDI were 2.4 (3.5) and 1.3 (1.5), respectively. The mean FACIT-FT was 33.1 (10.8). On the multivariable analysis, age at diagnosis and some domains of HRQoL (physical health, emotional health and fatigue) remained associated. Conclusions Age at diagnosis is negatively associated with fatigue whereas HRQoL domains like physical health, emotional health and fatigue are positively associated with fatigue.

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