Abstract
The article presents the case analysis concerning the successful therapeutic treatment of multiple osteonecrosis in an adult female patient with the juvenile form of systemic lupus erythematosus (SLE), including an analysis of the risk factors for their development. A comprehensive approach, including limiting axial load on the hip joints, the use of bisphosphonates, teriparatide, nonsteroidal anti-inflammatory drugs (NSAIDs), and disease-modifying osteoarthritis drugs, resulted in pain reduction, slowing of structural progression of femoral head changes, and improved functional status of the patient. Disease-modifying treatment of osteoarthritis was conducted with alternating injectable and oral medications. The success in treating osteonecrosis in this female patient was also enabled by the adjustment of basic SLE therapy and the reduction of prednisone dosage to 1.25 mg/day. This case serves as a vivid illustration of what is referred to as "complicated comorbidity.» The comprehensive approach allowed for achieving sustained positive outcomes, thus postponing surgical intervention in a physically active young female patient. KEYWORDS: systemic lupus erythematosus, SLE, aseptic necrosis, risk factors, osteoarthritis, osteoporosis, basic therapy of osteoarthritis, DMOAD, bisphosphonates, glucocorticoids. FOR CITATION: Gaydukova I.Z., Musiychuk M.M., Bombina M.V., Aparkina A.V., Petukhova A.A., Filonenko E.P., Inamova O.V., Rebrov A.P. Сase of multi-focal osteonecrosis with secondary osteoarthritis and glucocorticoid-induced osteoporosis in an adult patient with juvenile- onset systemic lupus erythematosus — risk factors and modern treatment tactics. Russian Medical Inquiry. 2024;8(7):406–412 (in Russ.). DOI: 10.32364/2587-6821-2024-8-7-6.
Published Version
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