[A clinical study of femoral head osteonecrosis in patients with systemic lupus erythematosus.].

Objective: To investigate the clinical features of osteonecrosis of the femoral head (ONFH) in patients with systemic lupus erythematosus (SLE).

Methods: The consecutive 461 SLE patients who underwent inpatient care in China-Japan Friendship Hospital were reviewed, the clinical data of 32 cases complicated with ONFH and 64 without ONFH as control was studied.

Results: The incidence of ONFH in 461 SLE patients was 6.94%. 65.63% of the ONFH was diagnosed within the first 3 years of SLE. It was found that the incidence of vasculitis, osteoporosis, high level of blood platelet, serum low density lipoprotein cholesterol (LDL-C) and fibrinogen was higher in SLE patients with ONFH than that in SLE patients without ONFH (P < 0.05). When compared with controls, the ONFH initial glucocorticoid dosage and accumulative dosage of glucocorticoid within the first month or six months were significantly higher in SLE patients with ONFH (P < 0.05). There was no significant difference between two groups in sex, age, duration of SLE, dental ulcer, Raynaud's phenomenon, hypocalcemia, renal diseases, hypertension, anemia, positive anticardiolipin antibodies and immunosuppresive treatment (P > 0.05).

Conclusion: The incidence of ONFH in patients with SLE is relatively high within the first 3 years of SLE. The SLE patients with ONFH are more likely to have such clinical features as vasculitis, osteoporosis, high level of blood platelet, serum LDL-C and fibrinogen and exposed to high-dose glucocorticoid therapy.