Aseptic necrosis of bone in systemic lupus erythematosus. Relationship to corticosteroid therapy

Abstract

The relationship of corticosteroid therapy to the development of aseptic necrosis (AN) in 365 patients with systemic lupus erythematosus (SLE) was investigated. Seventeen patients (4.7%) had AN. The dosage of corticosteroids ingested during the initial period of therapy in patients with AN was tabulated and compared with that of 25 SLE control patients. There was a substantially greater dose of costicosteroids ingested in the first 1, 3 and 6 mo. of therapy in the patients with AN than in the control SLE group. Severity of disease and duration of therapy did not correlate with AN. Total corticosteroid dose was virtually identical in both groups. Thus, high initial corticosteroid dosages in patients with SLE may be associated with the development of AN.