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Patellar tendon rupture in systemic lupus erythematosus
1Department of Medicine, Temple University Hospital, Philadelphia, PA.
The Journal of Rheumatology
|June 1, 1989
Summary
Systemic lupus erythematosus patients on long-term prednisone therapy may face increased risk of patellar tendon rupture, especially with existing arthritis and minimal disease activity.
Area of Science:
- Rheumatology
- Orthopedics
- Immunology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
- Tendon ruptures are a known complication, but their association with SLE requires further investigation.
Observation:
- Four out of 180 SLE patients experienced patellar tendon rupture over 10 years.
- These patients had long disease duration (7-20 years), were in clinical remission, and had deforming hand arthritis.
- All patients were on long-term prednisone (7-15 years) and exhibited steroid-related side effects like compression fractures and osteonecrosis.
Findings:
- SLE-associated tendon rupture correlates with extended disease duration and chronic corticosteroid use.
- Minimal disease activity, deforming hand arthropathy, and steroid-induced musculoskeletal complications are significant predictors.
- No tendon ruptures were reported in SLE patients not on chronic corticosteroid therapy.
Implications:
- Clinicians should monitor SLE patients on long-term corticosteroids for signs of tendon rupture.
- Early recognition of risk factors can prevent severe musculoskeletal complications in SLE patients.
- Further research into the mechanisms linking SLE, corticosteroids, and tendon pathology is warranted.