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Lupus. 1992 Dec;1(6):401-5.

High-dose intravenous methylprednisolone therapy associated with osteonecrosis in patients with systemic lupus erythematosus.

Author information

1
Servicio de Medicina, Hospital Dr Sótero del Río, Santiago, Chile.

Abstract

Osteonecrosis is related to the use of steroids in patients with systemic lupus erythematosus (SLE); its association with the use of 'pulses' of methylprednisolone (PMP) is not clear at present. In a retrospective analysis of 190 patients with SLE we found that 19% of 36 patients treated with PMP had osteonecrosis compared with 6% of 154 patients without that treatment (P < 0.04). Risk factors associated with osteonecrosis were PMP treatment, cushingoid appearance, steroid doses > or = 40 mg/day during the first month of treatment, a ratio of steroid dose in grams/year > or = 12, hematuria and proteinuria. In a stepwise regression model, when cushingoid appearance was excluded, PMP became the only significant factor (P = 0.045). We conclude that osteonecrosis can be considered a long-term complication of PMP treatment in SLE patients.

PMID:
1304409
DOI:
10.1177/096120339200100610
[Indexed for MEDLINE]

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