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    V. M. Kovalenko, H. O. Protsenko, V. V. Dubas

    ANALYSIS OF RISK FACTORS AND ASSESSMENT OF THE COURSE OF AVASCULAR NECROSIS OF THE FEMORAL HEAD IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS


    About the author: V. M. Kovalenko, H. O. Protsenko, V. V. Dubas
    Heading CLINICAL MEDICINE
    Type of article Scentific article
    Annotation Avascular necrosis of the femoral head is, although relatively rare, one of the most serious complications of systemic lupus erythematosus. The study focuses on searching for clinical and laboratory features of patients suffering from this complication, as well as on studying its consequences. Data from 149 patients with systemic lupus erythematosus were analyzed, 13 of whom were diagnosed with avascular necrosis of the femoral head. These patients were found to have significantly higher total doses of glucocorticoids, levels of cholesterol and uric acid in serum (at the time of diagnosis of the femoral head avascular necrosis); among clinical presentations, alopecia, lymphopenia and vascular pathology are more common. It has been established that the late age of systemic lupus erythematosus onset correlates with the early development of avascular necrosis of the femoral head. When analyzing the course of the disease, it was revealed that in 9 out of 13 patients, there was a need for arthroplasty of one or both hip joints. Thus, the issue of identifying risk factors and prevention of this complication is especially relevant; consequently, the description of even a small group of such patients may in the future help to study this problem comprehensively.
    Tags systemic lupus erythematosus,avascular necrosis of the femoral head,risk factor,hip arthroplasty
    Bibliography
    • Adesina O, Brunson A, Keegan THM, Wun T. Osteonecrosis of the femoral head in sickle cell disease: prevalence, comorbidities, and surgical outcomes in California. Blood Adv. 2017;1(16):1287–1295. doi: 10.1182/bloodadvances.2017005256.
    • Barney J, Piuzzi NS, Akhondi H. Femoral Head Avascular Necrosis. 2021; Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm. nih.gov/books/NBK546658/.
    • Liu BY, Yang L, Wang BJ, Wang ZH, Cheng LL, Xie H, et al. Prevention for glucocorticoid-induced osteonecrosis of femoral head: a long-term clinical follow-up trail. 2017;97(41):3213–3218. doi: 10.3760/cma.j.issn.0376-2491.2017.41.004.
    • Moya-Angeler J, Gianakos AL, Villa JC, Ni A, Lane JM. Current concepts on osteonecrosis of the femoral head. World J Orthop. 2015;6(8):590–601. doi: 10.5312/wjo.v6.i8.590.
    • Narayanan A, Khanchandani P, Borkar RM, Ambati CR, Roy A, Han X, et al. Avascular Necrosis of Femoral Head: A Metabolomic, Biophysical, Biochemical, Electron Microscopic and Histopathological Characterization. Sci Rep. 2017;7(1):10721. doi: 10.1038/s41598-017-10817-w.
    • Nevskaya T, Gamble MP, Pope JE. A meta-analysis of avascular necrosis in systemic lupus erythematosus: prevalence and risk factors. Clin Exp Rheumatol. 2017;35(4):700–710.
    • Qijiao W, Meng Z, Jianwen L, Shengli Z, Fei G, He L, Zhihan C. Antiphospholipid antibodies and osteonecrosis in systemic lupus erythematosus: a meta-analysis. Expert Rev Clin Immunol. 2021;17(8):923–932. doi: 10.1080/1744666X.2021.1925109.
    • Rampal V, Clément JL, Solla F. Legg-Calvé-Perthes disease: classifications and prognostic factors. Clin Cases Miner Bone Metab. 2017;14(1):74–82. doi: 10.11138/ccmbm/2017.14.1.074.
    • Shah KN, Racine J, Jones LC, Aaron RK. Pathophysiology and risk factors for osteonecrosis. Curr Rev Musculoskelet Med. 2015;8(3):201-9. doi: 10.1007/s12178-015-9277-8.
    • Shaharir SS, Chua SH, Mohd R, Mustafar R, Noh MM, Shahril NS, et al. Risk factors for symptomatic Avascular Necrosis (AVN) in a multi-ethnic Systemic Lupus Erythematosus (SLE) cohort. PLoS One. 2021;16(3):e0248845. doi: 10.1371/journal.pone.0248845.
    • Sheikh M, Movassaghi S, Khaledi M, Moghaddassi M. Hyperuricemia in systemic lupus erythematosus: is it associated with the neuropsychiatric manifestations of the disease? Rev Bras Reumatol Engl Ed. 2016;56(6):471–477. doi: 10.1016/j.rbre.2015.07.011.
    • Valigura, M. Effect of elevated levels of uric acid on thrombocyte hemostasis in patients with hypertonic disease of stage ІІ. J Ed, Health Sport. 2018;8(10):285–293. doi: 10.5281/zenodo.1478858.
    • Xie XH, Wang XL, Yang HL, Zhao DW, Qin L. Steroid-associated osteonecrosis: Epidemiology, pathophysiology, animal model, prevention, and potential treatments (an overview). J Orthop Translat. 2015;3(2):58–70. doi: 10.1016/j.jot.2014.12.002.
    • Yang Z, Liu H, Li D, Xie X, Qin T, Ma J, Kang P. The efficacy of statins in preventing glucocorticoid-related osteonecrosis in animal models: A meta-analysis. Bone Joint Res. 2016;5(9):393–402. doi: 10.1302/2046-3758.59.2000500.
    • Zhao D, Zhang F, Wang B, Liu B, Li L, Kim SY, et al. Guidelines for clinical diagnosis and treatment of osteonecrosis of the femoral head in adults (2019 version). J Orthop Translat. 2020; 21:100–110. doi: 10.1016/j.jot.2019.12.004.
    Publication of the article «World of Medicine and Biology» №1(83), 2023 year, 091-095 pages, index UDK 616.5-005.525.2-036+616.718.41-002.4-02
    DOI 10.26724/2079-8334-2023-1-83-91-95