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.

Ayurvedic Management of Systemic Lupus Erythematosus Overlap Vasculitis vis a vis Vatarakta - A Case Report

2018 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Gururaja D. ◽  
Dr. Veeraj Hegde
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Lupus Erythematosus ◽  
Severe Pain ◽  
Overlap Syndrome ◽  
Burning Sensation ◽  
Tinospora Cordifolia ◽  
Systemic Lupus ◽  
Multisystem Disease

Systemic Lupus erythematosus is the classic prototype of multisystem disease of autoimmune origin. SLE may be associated Vasculitis as an overlap syndrome. In this paper, a patient diagnosed as SLE with Vasculitis, which was managed successfully by Ayurveda treatment is discussed. A 39 year old female patient came to hospital with complaint of severe pain and burning sensation in both the legs for two months, associated with ulceration and gangrene of toes of both the legs for the last 15 days. She was diagnosed as SLE overlap vasculitis at a higher medical centre with relevant investigations and advised to go for amputation. As patient was not willing for surgery came to Ayurveda treatment. The condition was diagnosed as disease Vatarakta and treatment was planned accordingly. Treatment was planned by selecting suitable oral medicines, planning suitable Panchakarma procedures along with the ulcer management. Guduchi (Tinospora cordifolia) was the main drug which is used in Rasayana dosage. Patient responded well and we could able to save the limb. Patient was under follow up for more than a year without any complications and relapses.

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.

scholarly journals Total Hip Arthroplasty in Systemic Lupus Erythematosus: A Systematic Review

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
John W. Kennedy ◽  
Wasim Khan
Keyword(s):  
Systematic Review ◽  
Systemic Lupus Erythematosus ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lupus Erythematosus ◽  
Postoperative Outcomes ◽  
Harris Hip Score ◽  
Systemic Lupus ◽  
Total Hip

The prognosis of systemic lupus erythematosus (SLE) has greatly improved in recent years, resulting in an increased number of patients reporting musculoskeletal complications such as osteonecrosis of the femoral head. Total hip arthroplasty (THA) can be utilised to alleviate the pain associated with this; however postoperative outcomes in patients with SLE are uncertain. A systematic review of the literature was conducted to identify articles presenting results of THA in SLE, and nine suitable papers were found. All papers were level IV evidence. Pooling the results, a total of 162 patients underwent 214 total hip arthroplasties. Mean follow-up was 72.5 months. The mean Harris Hip Score improved from 45.5 preoperatively to 88.6 and last follow-up. Seventeen percent of patients experienced at least one complication. Superficial wound infection occurred in 3.3%. Revision was required in 2.8% of cases. The mortality rate was 18.5% however no deaths were attributable to undergoing THA. Given the paucity of data present in the literature, more studies are required to adequately assess the postoperative outcomes of THA in patients with SLE, particularly complication rates.

scholarly journals Primary antiphospholipid syndrome progressing to systemic lupus erythematosus: a case report

2013 ◽  
pp. 116-121
Author(s):  
Rocco Manganelli ◽  
Salvatore Iannaccone ◽  
Walter De Simone
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Antiphospholipid Syndrome ◽  
Lupus Erythematosus ◽  
Primary Antiphospholipid Syndrome ◽  
Systemic Lupus ◽  
Anionic Phospholipids ◽  
Serological Studies ◽  
Homogeneous Pattern

Introduction: Primary antiphospholipid syndrome (APS) is a thrombophilic disease that should be suspected in the presence of thrombotic events associated with hematologic abnormalities such as thrombocytopenia and prolongation of the activated partial thromboplastin time. The diagnosis must be confirmed by the demonstration of autoantibodies directed against anionic phospholipids and/or phospholipid-binding proteins. The disease can cause arterial thrombosis in any vascular district, including those of the kidney and central nervous system. Case report: In 2006 a 29-year-old male presented with kidney and brain involvement that was attributed to primary APS. The clinical diagnosis was confirmed by the results of a renal biopsy, which excluded the presence of systemic lupus erythematosus (SLE). The patient remained stable through 32 months of follow-up and then developed a malar rash with deteriorating renal function, decreasing platelet count, and reduced complement levels. Serological studies revealed positivity for ANA (homogeneous pattern), dsDNA, ACA, and beta-2-glycoprotein-1 antibodies. The diagnosis was revised to APS secondary to SLE. Conclusions: A diagnosis of primary APS should not be considered permanent: progression to SLE can occur, in some cases years after the original diagnosis. This case highlights the importance of ongoing follow-up of patients diagnosed with primary APS to detect changes that herald the emergence of SLE.

Sensorineural hearing loss in systemic lupus erythematosus: case report and literature review

2008 ◽  
Vol 122 (12) ◽  
pp. 1371-1376 ◽  
Author(s):  
N A Khalidi ◽  
R Rebello ◽  
D D Robertson
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systemic Lupus Erythematosus ◽  
Hearing Loss ◽  
Case Report ◽  
Sensorineural Hearing Loss ◽  
Lupus Erythematosus ◽  
Sensorineural Hearing ◽  
Resonance Imaging ◽  
Systemic Lupus

AbstractObjectives:We present a case of systemic lupus erythematosus with symptomatic sensorineural hearing loss which was successfully treated with azathioprine, as assessed both clinically and radiologically. We also present a review of the relevant literature.Case report:A woman with systemic lupus erythematosus presented with sensorineural hearing loss, initially on the right and subsequently developing on the left over several months. An audiogram revealed profound neurosensory hearing loss bilaterally. The patient was treated with prednisone 60 mg daily and azathioprine 200 mg daily. An improvement on the left was noted on follow-up audiography as well as on magnetic resonance imaging of the internal auditory canals and surrounding structures.Conclusion:Sensorineural hearing loss has been described in autoimmune disorders but is rare. Aural symptoms have been described, with varying incidences (0–57.5 per cent), in systemic lupus erythematosus. However, symptomatic sensorineural hearing loss is rare in systemic lupus erythematosus. Prednisone appears essential when an immunological or vasculitic cause is found. The use of azathioprine should be considered, as well as follow-up with magnetic resonance imaging to detect improvement.

scholarly journals Systemic lupus erythematosus in pregnancy: Case report

2005 ◽  
Vol 58 (5-6) ◽  
pp. 301-307
Author(s):  
Gordana Radeka ◽  
Aleksandra Novakov-Mikic ◽  
Igor Mitic
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Lupus Erythematosus ◽  
Intrauterine Growth Retardation ◽  
Fetal Death ◽  
Intrauterine Fetal Death ◽  
Systemic Lupus ◽  
Fertile Period ◽  
Intrauterine Growth

Systemic lupus erythematosus (SLE) is a chronic inflammatory connective tissue disease commonly diagnosed after the age of 20, mostly around the age of 30 years. It is more common in women than in men, especially during the fertile period. Women with SLE are at higher risk for spontaneous abortions, intrauterine fetal death, preeclampsia and eclampsia, preterm delivery and intrauterine growth retardation. This paper is a case report of a pregnant woman with SLE complicated with preeclampsia, but it also discusses follow-up of such pregnancies.

Core Decompression for Osteonecrosis of the Femoral Head in Systemic Lupus Erythematosus

1997 ◽  
Vol 334 ◽  
pp. 91???97 ◽  
Author(s):  
MICHAEL A. MONT ◽  
ADRIAN C. FAIRBANK ◽  
MICHELLE PETRI ◽  
DAVID S. HUNGERFORD
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Femoral Head ◽  
Lupus Erythematosus ◽  
Core Decompression ◽  
Systemic Lupus

Endocrine malignancies and systemic lupus erythematosus: case report

2019 ◽  
Author(s):  
Nadia Ghariani Fetoui ◽  
Rima Gammoudi ◽  
Najet Ghariani ◽  
Yosra Hasni ◽  
Racha Fekih ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Systemic Lupus Erythematosus Case
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