Document Detail

Steroid induced osteonecrosis: An analysis of steroid dosing risk.
MedLine Citation:
PMID:  20621176     Owner:  NLM     Status:  MEDLINE    
Osteonecrosis is a serious condition involving bone destruction that frequently requires surgical treatment to rebuild the joint. While there is an abundance of literature documenting corticosteroid related osteonecrosis, there is no consensus as to the relative risk of osteonecrosis after administration of steroids via parenteral, oral, topical, inhaled and other routes. This risk is an important prognostic indicator because identification and conservative intervention can potentially reduce morbidity associated with aggressive surgical treatment of osteonecrosis. This paper provides insight into establishing guidelines related to the risk of developing osteonecrosis as a result of corticosteroid use. Case studies, retrospective studies and prospective studies in humans on different corticosteroids and varied dosages were assessed. Most cases of osteonecrosis are secondary to systemically administered corticosteroids and/or high dose daily therapy, particularly in patients with underlying comorbidities including connective tissue diseases, hyperlipidemia, or previous trauma. Previous case reports of osteonecrosis related to inhaled or topical use of steroids are complicated by the fact that in the great majority of cases, the patients are also treated with systemic steroids prior to the development of osteonecrosis. Based on the literature, a set of recommendations regarding the risk of osteonecrosis in patients on steroids was formulated.
Christian Powell; Christopher Chang; Stanley M Naguwa; Gurtej Cheema; M Eric Gershwin
Related Documents :
18813426 - Severe hepatic dysfunction after sevoflurane exposure.
11316096 - Dorzolamide-induced immune thrombocytopenia: a case report and literature review.
10852096 - Clozapine-induced hypersalivation.
8986316 - Probable nefazodone-induced mania in a patient with unreported bipolar disorder.
9495376 - Late-onset warfarin-induced skin necrosis: case report and review of the literature.
19087866 - Reported cases of congenital syphilis in the french national hospital database.
Publication Detail:
Type:  Journal Article; Review     Date:  2010-07-09
Journal Detail:
Title:  Autoimmunity reviews     Volume:  9     ISSN:  1873-0183     ISO Abbreviation:  Autoimmun Rev     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-03     Completed Date:  2010-12-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101128967     Medline TA:  Autoimmun Rev     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  721-43     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier B.V. All rights reserved.
Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, Davis, CA 95616, United States.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Administration, Oral
Adrenal Cortex Hormones / administration & dosage,  adverse effects*
Bone Density / drug effects*
Bone and Bones / drug effects
Dose-Response Relationship, Drug
Glucocorticoids / administration & dosage,  adverse effects
Immunosuppressive Agents / administration & dosage,  adverse effects
Infusions, Parenteral
Osteonecrosis / chemically induced*
Steroids / administration & dosage,  adverse effects*
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Glucocorticoids; 0/Immunosuppressive Agents; 0/Steroids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Absorption and tissue tolerance of ricobendazole in the presence of hydroxypropyl-beta-cyclodextrin ...
Next Document:  Erratum to "Appraisal of scopolamine-induced antiamnesic effect in mice and in vitro antiacetylcholi...