Extended report
Risk factors for avascular necrosis of bone in patients with
systemic lupus erythematosus: Is there a role for
antiphospholipid antibodies?
M Y Moka, V T Farewellb, D A Isenberga
a Bloomsbury
Rheumatology Unit, University College London Medical School, London, b Department
of Statistical Science, University College London Medical School,
London
Correspondence to: Dr M Y Mok, University Department of Medicine, Division of Rheumatology, 4/F Professorial Block, Queen Mary Hospital, Pokfulam Road, Hong Kong Email: mymok{at}netvigator.com
Accepted for publication 22 November 1999
BACKGROUND
Avascular
necrosis of bone (AVN) is a well known complication in patients with
systemic lupus erythematosus (SLE).
OBJECTIVETo
investigate the role of antiphospholipid antibody status (IgM and
IgG anticardiolipin antibodies and lupus anticoagulant) with adjustment
for corticosteroid use as risk factors for the development of AVN.
METHODS A cohort of
265 patients receiving long term follow up in our SLE clinic from 1978 to 1998 was analysed. Patients with AVN complications were detected and
then matched for age, sex, ethnicity, duration of disease, and organ
disease with two other patients with SLE. A further 31 patients were
chosen at random for the analysis.
RESULTSEleven
patients had AVN, giving a point prevalence of 4%. There were no
significant differences demonstrable in the presence of individual
antiphospholipid antibodies (aPL) or their combination between the
group with AVN or the two control groups.
CONCLUSIONIncorporating
an adjustment for corticosteroid use we were unable to show a link
between the presence of aPL and the development of AVN in patients with SLE.
© 2000 by Annals of the Rheumatic Diseases
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