Avascular necrosis in pediatric systemic lupus erythematosus: a brief report and review of the literature

Reut Gurion, Vin Tangpricha, Eric Yow, Laura E Schanberg, Grace A McComsey, Angela Byun Robinson, Atherosclerosis Prevention in Pediatric Lupus Erythematosus Investigators, Esi Morgan Dewitt, C Egla Rabinovich, Janet Ellis, Janet Wootton, Peter Chira, Joyce Hsu, Tzielan Lee, Jan Perea, Beth Gottlieb, Patricia Irigoyen, Jennifer Luftig, Shaz Siddiqi, Zhen Ni, Marilynn Orlando, Eileen Pagano, Andrew Eichenfield, Deborah Levy, Philip Kahn, Candido Batres, Digna Cabral, Kathleen A Haines, Suzanne C Li, Jennifer Weiss, Mary Ellen Riordan, Beena Vaidya, Michelle Mietus-Snyder, Lawrence Ng, Susan Ballinger, Thomas Klausmeier, Debra Hinchman, Andrea Hudgins, Shirley Henry, Shuzen Zhang, Elizabeth B Brooks, Stacy Miner, Nancy Szabo, Lisabeth Scalzi, Libby Dorfeld, Sarajane Wilson, Jenna Tress, Tatiana Hernandez, Jyotsna Vitale, Angela Kress, Nicole Lowe, Falguni Patel, Stephanie Hamilton, Katie Caldwell, Diane Kamen, Becky Puplava, Atanas Lonchev, Monica Bacani, Cynthia Rutherford, Jamie Meyers-Eaton, Shannen Nelson, Alexei Grom, Teresa Conway, Lacey Frank, Lori Kuss, Hazel Senz, Thomas Mason, Jane Jaquith, Diana E Paepke-Tollefsrud, Reut Gurion, Vin Tangpricha, Eric Yow, Laura E Schanberg, Grace A McComsey, Angela Byun Robinson, Atherosclerosis Prevention in Pediatric Lupus Erythematosus Investigators, Esi Morgan Dewitt, C Egla Rabinovich, Janet Ellis, Janet Wootton, Peter Chira, Joyce Hsu, Tzielan Lee, Jan Perea, Beth Gottlieb, Patricia Irigoyen, Jennifer Luftig, Shaz Siddiqi, Zhen Ni, Marilynn Orlando, Eileen Pagano, Andrew Eichenfield, Deborah Levy, Philip Kahn, Candido Batres, Digna Cabral, Kathleen A Haines, Suzanne C Li, Jennifer Weiss, Mary Ellen Riordan, Beena Vaidya, Michelle Mietus-Snyder, Lawrence Ng, Susan Ballinger, Thomas Klausmeier, Debra Hinchman, Andrea Hudgins, Shirley Henry, Shuzen Zhang, Elizabeth B Brooks, Stacy Miner, Nancy Szabo, Lisabeth Scalzi, Libby Dorfeld, Sarajane Wilson, Jenna Tress, Tatiana Hernandez, Jyotsna Vitale, Angela Kress, Nicole Lowe, Falguni Patel, Stephanie Hamilton, Katie Caldwell, Diane Kamen, Becky Puplava, Atanas Lonchev, Monica Bacani, Cynthia Rutherford, Jamie Meyers-Eaton, Shannen Nelson, Alexei Grom, Teresa Conway, Lacey Frank, Lori Kuss, Hazel Senz, Thomas Mason, Jane Jaquith, Diana E Paepke-Tollefsrud

Abstract

Avascular necrosis (AVN) occurs in several chronic illnesses, including systemic lupus erythematosus (SLE), but can also occur in healthy children. There are multiple theories to explain why and how AVN occurs, but an exact mechanism has yet to be unraveled. AVN in the pediatric lupus population is understudied. The Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) trial, provides an excellent venue to conduct an exploratory analysis to assess associations between AVN and demographics, SLE disease activity and vitamin D deficiency. Herein we present a brief report describing our findings, as well as reviewing the literature on AVN in SLE and other entities.

Trial registration: ClinicalTrials.gov identifier: NCT00065806.

Figures

Figure 1
Figure 1
AVN in a SLE patient.
Figure 2
Figure 2
Osteonecrosis in a patient with acute myeloid leukemia.
Figure 3
Figure 3
Slipped capital femoral epiphysis (SCFE).
Figure 4
Figure 4
Legg-Calvé-Perthes’ disease (LCPD).

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