• Ismail Doğan, Umut Kalyoncu, Levent Kiliç, Ali Akdoğan, Ömer Karadağ, Sedat Kiraz, Şule A Bilgen, and Ihsan Ertenli.
• Division of Rheumatology, Department of Internal Medicine, Yıldırım Beyazıt University, Ankara, Turkey
• Turk J Med Sci. 2020 Feb 13; 50 (1): 219-224.

Background/AimAvascular necrosis (AVN) is the death of bone due to compromise of blood flow. The etiology of AVN is multifactorial; corticosteroid usage is the second most significant factor after trauma, and systemic lupus erythematosus (SLE) is the most common underlying disease. The objective of this study was to assess the factors of AVN in SLE patients.Materials And MethodsThe study included 127 patients with SLE who fulfilled 1997 American College of Rheumatology (ACR) revised criteria. Demographic data, age at SLE diagnosis, disease duration, disease activity, body mass index, clinical findings, antiphospholipid syndrome, steroid usage, dose and duration, comorbid diseases, and smoking history were recorded.ResultsAVN was found in 11 of 127 (8.7%) SLE patients. Hyperlipidemia (P < 0.001), cushingoid body habitus (P < 0.001), and proteinuria (P = 0.013) were found at higher rates in the AVN group. All of the 11 AVN cases had osteoporosis (P < 0.02). In multivariate regression analysis, daily steroid usage was the only factor for development of AVN in SLE.ConclusionThe hypothesis of our study was that an alternate day steroid regimen may decrease AVN frequency in SLE patients.This work is licensed under a Creative Commons Attribution 4.0 International License.

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