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

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%) were identified as having 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 one, three, and six months of therapy in the patients with AN than in the control SLE group. Severity of disease and duration of therapy were not found to correlate with AN. Total corticosteroid dose was virtually identical in both groups. Thus, high initial corticosteroid dosages in patients with SLE seem to be associated with the development of AN.