Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Experimental and Therapeutic Medicine
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-0981 Online ISSN: 1792-1015
Journal Cover
October-2019 Volume 18 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
October-2019 Volume 18 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Case Report Open Access

Multifocal osteonecrosis affecting all four limbs in systemic lupus erythematosus: A case report

  • Authors:
    • Siqiao Sun
    • Qi Wang
    • Yubao Gong
    • Xin Qi
    • Jianguo Liu
  • View Affiliations / Copyright

    Affiliations: Department of Vascular Surgery, The First Hospital of Jilin University, Jilin, Changchun 130021, P.R. China, Department of Bone and Joint Surgery, The First Hospital of Jilin University, Jilin, Changchun 130021, P.R. China
    Copyright: © Sun et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 2475-2478
    |
    Published online on: July 30, 2019
       https://doi.org/10.3892/etm.2019.7829
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

Osteonecrosis is a condition that frequently affects patients with systemic lupus erythematosus (SLE). However, reports on severe multifocal osteonecrosis involving more than three anatomical sites in patients with SLE are scarce. The present study describes a case of SLE with multifocal osteonecrosis involving all four limbs. A 22‑year‑old woman was diagnosed with SLE in 2010 and the disease was controlled by treatment with methylprednisolone and hydroxychloroquine. Approximately 1 year following the diagnosis of SLE, the patient developed pain in the elbows and hips. Magnetic resonance imaging revealed evidence of multifocal osteonecrosis in the bilateral distal segments of the humerus and femoral head, the distal segment of the right femur and the proximal segment of the right tibia. The patient was treated with right total hip arthroplasty and core decompression of the right femur and tibia, followed by continuation of the earlier medical treatment for SLE. The present case highlights the importance of conducting a careful investigation of patients with SLE who present with multiple joint involvement, and the choice of the appropriate treatment according to the presentation.
View Figures

Figure 1

View References

1 

Assouline-Dayan Y, Chang C, Greenspan A, Shoenfeld Y and Gershwin ME: Pathogenesis and natural history of osteonecrosis. Semin Arthritis Rheum. 32:94–124. 2002. View Article : Google Scholar : PubMed/NCBI

2 

Dubois EL and Cozen L: Avascular (aseptic) bone necrosis associated with systemic lupus erythematosus. JAMA. 174:966–971. 1960. View Article : Google Scholar : PubMed/NCBI

3 

Abu-Shakra M, Buskila D and Shoenfeld Y: Osteonecrosis in patients with SLE. Clin Rev Allergy Immunol. 25:13–24. 2003. View Article : Google Scholar : PubMed/NCBI

4 

Zhang K, Zheng Y, Jia J, Ding J and Wu Z: Systemic lupus erythematosus patients with high disease activity are associated with accelerated incidence of osteonecrosis: A systematic review and meta-analysis. Clin Rheumatol. 37:5–11. 2018. View Article : Google Scholar : PubMed/NCBI

5 

Cavallasca JA, Laborde HA, Araujo MB and Nasswetter GG: Multiple avascular necrosis in a patient with systemic lupus erythematosus/systemic sclerosis overlap syndrome. Clin Rheumatol. 24:406–408. 2005. View Article : Google Scholar : PubMed/NCBI

6 

Darlington LG: Osteonecrosis at multiple sites in a patient with systemic lupus erythematosus. Ann Rheum Dis. 44:65–66. 1985. View Article : Google Scholar : PubMed/NCBI

7 

Fajardo-Hermosillo LD, López-López L, Nadal A and Vilá LM: Multifocal osteonecrosis in systemic lupus erythematosus: Case report and review of the literature. BMJ Case Rep. 2013:bcr20130089802013. View Article : Google Scholar : PubMed/NCBI

8 

Fishel B, Caspi D, Eventov I, Avrahami E and Yaron M: Multiple osteonecrotic lesions in systemic lupus erythematosus. J Rheumatol. 14:601–604. 1987.PubMed/NCBI

9 

García-Miguel J, Calvet-Fontova J, Maymó-Guarsch J and Carbonell-Abelló J: Multifocal osteonecrosis in a patient with systemic lupus erythematosus. Med Clin (Barc). 127:2762006.(In Spanish). View Article : Google Scholar

10 

Greenhagen RM, Crim BE, Shinabarger AB and Burns PR: Bilateral osteonecrosis of the navicular and medial cuneiform in a patient with systemic lupus erythematosus: A case report. Foot Ankle Spec. 5:180–184. 2012. View Article : Google Scholar : PubMed/NCBI

11 

Guillaume MP, Brandelet B and Peretz A: Unusual high frequency of multifocal lesions of osteonecrosis in a young patient with systemic lupus erythematosus. Br J Rheumatol. 37:1248–1249. 1998. View Article : Google Scholar : PubMed/NCBI

12 

Lawal YZ, Ogirima MO, Dahiru IL, Maitama MI, Ejagwulu FS and Abubakar K: Bilateral osteonecrosis of the femoral heads in a patient with systemic lupus erythematosus. Ann Afr Med. 10:64–65. 2011. View Article : Google Scholar : PubMed/NCBI

13 

Outwater E, Oates E and Sarno RC: Bilateral distal tibial osteonecrosis in systemic lupus erythematosus. AJR Am J Roentgenol. 152:895–896. 1989. View Article : Google Scholar : PubMed/NCBI

14 

Salesi M, Karimifar M, Mottaghi P, Sayedbonakdar Z and Karimzadeh H: A case of SLE with bilateral osteonecrosis of femoral heads and bone infarct in distal of femur. Rheumatol Int. 30:527–529. 2010. View Article : Google Scholar : PubMed/NCBI

15 

Seymour MW, Mitchell AW and Mackworth-Young CG: Bilateral calcaneal osteonecrosis in a patient with systemic lupus erythematosus. Rheumatology (Oxford). 44:5862005. View Article : Google Scholar : PubMed/NCBI

16 

Shimizu M, Tokuhisa Y, Ishikawa S, Ueno K, Yokoyama T and Yachie A: Multiple osteonecrosis in a patient with juvenile systemic lupus erythematosus. J Clin Rheumatol. 19:1602013. View Article : Google Scholar : PubMed/NCBI

17 

Bossuyt X, Frans J, Hendrickx A, Godefridis G, Westhovens R and Mariën G: Detection of anti-SSA antibodies by indirect immunofluorescence. Clin Chem. 50:2361–2369. 2004. View Article : Google Scholar : PubMed/NCBI

18 

Abeles M, Urman JD and Rothfield NF: Aseptic necrosis of bone in systemic lupus erythematosus. Relationship to corticosteroid therapy. Arch Intern Med. 138:750–754. 1978. View Article : Google Scholar : PubMed/NCBI

19 

Caramaschi P, Biasi D, Dal Forno I and Adami S: Osteonecrosis in systemic lupus erythematosus: An early, frequent, and not always symptomatic complication. Autoimmune Dis. 2012:7252492012.PubMed/NCBI

20 

Zizic TM: Osteonecrosis. Curr Opin Rheumatol. 3:481–489. 1991. View Article : Google Scholar : PubMed/NCBI

21 

Halland AM, Klemp P, Botes D, Van Heerden BB, Loxton A and Scher AT: Avascular necrosis of the hip in systemic lupus erythematosus: The role of magnetic resonance imaging. Br J Rheumatol. 32:972–976. 1993. View Article : Google Scholar : PubMed/NCBI

22 

Hungerford DS and Zizic TM II: The treatment of ischemic necrosis of bone in systemic lupus erythematosus. Medicine (Baltimore). 59:143–148. 1980. View Article : Google Scholar : PubMed/NCBI

23 

Ehmke TA, Cherian JJ, Wu ES, Jauregui JJ, Banerjee S and Mont MA: Treatment of osteonecrosis in systemic lupus erythematosus: A review. Curr Rheumatol Rep. 16:4412014. View Article : Google Scholar : PubMed/NCBI

24 

Mont MA, Glueck CJ, Pacheco IH, Wang P, Hungerford DS and Petri M: Risk factors for osteonecrosis in systemic lupus erythematosus. J Rheumatol. 24:654–662. 1997.PubMed/NCBI

25 

Zhu KK, Xu WD, Pan HF, Zhang M, Ni J, Ge FY and Ye DQ: The risk factors of avascular necrosis in patients with systemic lupus erythematosus: A meta-analysis. Inflammation. 37:1852–1864. 2014. View Article : Google Scholar : PubMed/NCBI

26 

Sayarlioglu M, Yuzbasioglu N, Inanc M, Kamali S, Cefle A, Karaman O, Onat AM, Avan R, Cetin GY, Gul A, et al: Risk factors for avascular bone necrosis in patients with systemic lupus erythematosus. Rheumatol Int. 32:177–182. 2012. View Article : Google Scholar : PubMed/NCBI

27 

Zen M, Canova M, Campana C, Bettio S, Nalotto L, Rampudda M, Ramonda R, Iaccarino L and Doria A: The kaleidoscope of glucorticoid effects on immune system. Autoimmun Rev. 10:305–310. 2011. View Article : Google Scholar : PubMed/NCBI

28 

De Nijs RN: Glucocorticoid-induced osteoporosis: A review on pathophysiology and treatment options. Minerva Med. 99:23–43. 2008.PubMed/NCBI

29 

Weldon D: The effects of corticosteroids on bone: Osteonecrosis (avascular necrosis of the bone). Ann Allergy Asthma Immunol. 103:91–97. 2009. View Article : Google Scholar : PubMed/NCBI

30 

Zizic TM, Marcoux C, Hungerford DS, Dansereau JV and Stevens MB: Corticosteroid therapy associated with ischemic necrosis of bone in systemic lupus erythematosus. Am J Med. 79:596–604. 1985. View Article : Google Scholar : PubMed/NCBI

31 

Vande Berg BC, Malghem J, Lecouvet FE, Devogelaer JP, Maldague B and Houssiau FA: Fat conversion of femoral marrow in glucocorticoid-treated patients: A cross-sectional and longitudinal study with magnetic resonance imaging. Arthritis Rheum. 42:1405–1411. 1999. View Article : Google Scholar : PubMed/NCBI

32 

Mont MA and Jones LC: Management of osteonecrosis in systemic lupus erythematosus. Rheum Dis Clin North Am. 26279–309. (vi)2000. View Article : Google Scholar : PubMed/NCBI

33 

Marker DR, Seyler TM, McGrath MS, Delanois RE, Ulrich SD and Mont MA: Treatment of early stage osteonecrosis of the femoral head. J Bone Joint Surg Am. 90 (Suppl 4):S175–S187. 2008. View Article : Google Scholar

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Sun S, Wang Q, Gong Y, Qi X and Liu J: Multifocal osteonecrosis affecting all four limbs in systemic lupus erythematosus: A case report. Exp Ther Med 18: 2475-2478, 2019.
APA
Sun, S., Wang, Q., Gong, Y., Qi, X., & Liu, J. (2019). Multifocal osteonecrosis affecting all four limbs in systemic lupus erythematosus: A case report. Experimental and Therapeutic Medicine, 18, 2475-2478. https://doi.org/10.3892/etm.2019.7829
MLA
Sun, S., Wang, Q., Gong, Y., Qi, X., Liu, J."Multifocal osteonecrosis affecting all four limbs in systemic lupus erythematosus: A case report". Experimental and Therapeutic Medicine 18.4 (2019): 2475-2478.
Chicago
Sun, S., Wang, Q., Gong, Y., Qi, X., Liu, J."Multifocal osteonecrosis affecting all four limbs in systemic lupus erythematosus: A case report". Experimental and Therapeutic Medicine 18, no. 4 (2019): 2475-2478. https://doi.org/10.3892/etm.2019.7829
Copy and paste a formatted citation
x
Spandidos Publications style
Sun S, Wang Q, Gong Y, Qi X and Liu J: Multifocal osteonecrosis affecting all four limbs in systemic lupus erythematosus: A case report. Exp Ther Med 18: 2475-2478, 2019.
APA
Sun, S., Wang, Q., Gong, Y., Qi, X., & Liu, J. (2019). Multifocal osteonecrosis affecting all four limbs in systemic lupus erythematosus: A case report. Experimental and Therapeutic Medicine, 18, 2475-2478. https://doi.org/10.3892/etm.2019.7829
MLA
Sun, S., Wang, Q., Gong, Y., Qi, X., Liu, J."Multifocal osteonecrosis affecting all four limbs in systemic lupus erythematosus: A case report". Experimental and Therapeutic Medicine 18.4 (2019): 2475-2478.
Chicago
Sun, S., Wang, Q., Gong, Y., Qi, X., Liu, J."Multifocal osteonecrosis affecting all four limbs in systemic lupus erythematosus: A case report". Experimental and Therapeutic Medicine 18, no. 4 (2019): 2475-2478. https://doi.org/10.3892/etm.2019.7829
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team