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Avascular necrosis

Avascular necrosis (more common in iatrogenic cases)... [Pg.694]

In leukemia, the intensified use of methotrexate and glucocorticoids is responsible for causing an increased frequency of neurotoxicity and, in older children and adults, avascular necrosis of bone. High cumulative doses of anthracyclines can cause cardiomyopathy. Cranial irradiation causes neuropsychologic deficits and endocrine abnormalities that lead to obesity, short stature, precocious puberty, and osteoporosis.3 As newer and more intensive treatments enter clinical trials, close observation for long-term side effects will assume even greater importance.24... [Pg.1412]

Short-term use of glucocorticoids, even in massive dosages, is less likely to produce harmful reactions. They can, however, produce a variety of effects that are neither limited to high doses nor to long-term therapy. When a low dose of steroids (prednisone) was given for several months to a 38-year-old man to treat eczema of his hands and feet, he developed bilateral avascular necrosis (AVN) of the femur. He therefore had total bilateral hip replacement, and several experts have attributed his AVN to the steroid administration. The man sued his allergist, who settled the lawsuit shortly before trial for approximately 400,000. Most practitioners, however, are unaware of the risk of short-term or low-dose steroids. Yet many of these cases can be found in the courts, the literature, and the MedWatch databases. [Pg.511]

Glucocorticoid-related complications have been described in 748 adult kidney transplant recipients, followed for at least 1 year. For bone/joint complications, the multivariate analysis showed that the only significant variable was the cumulative duration of glucocorticoid therapy. For avascular necrosis, no variables were significant (SEDA-19, 377 223). [Pg.28]

The risk of avascular necrosis has been assessed in a nested case-control study using computer records (268). There were 31 cases during 720 000 person-years Avascular necrosis was strongly associated with glucocorticoid exposure (RR = 16). When total prednisone exposure over 35 months was stratified into three levels (under 440 mg, 440-1290 mg, and over 1290 mg), there was no excess risk for cumulative doses of up to 440 mg (RR = 0 95% Cl = 0, 5). The relative risk was increased for doses between 440 and 1290 mg (RR = 6 Cl = 1, 43) and indeterminately increased at doses over 1290 mg (Cl = 26, infinity). [Pg.33]

In 15 men with osteonecrosis of the femoral head after short-term therapy the mean duration of therapy was 21 (range 7-39) days and the mean dose in milligram equivalents of prednisone was 850 (range 290-3300) mg (269). The time from administration of glucocorticoids to hip pain was 17 (range 6-33) months. A new case of bilateral avascular necrosis of the femoral heads after high-dose short-term dexamethasone therapy as an antiemetic in cancer chemotherapy has been reported (270). [Pg.33]

A 48-year-old woman developed avascular necrosis 9 months after she had completed a 3-month course of hydrocortisone 100 mg retention enemas once or twice daily for ulcerative proctitis (470). An MRI scan showed multiple bony infarcts in her distal femora, proximal tibiae, and posterior proximal right fibular head, extending from the diaphysis to the epiphysis, consistent with avascular necrosis. [Pg.52]

Bauer M, Thabault P, Estok D, Chrinstiansen C, Platt R. Low-dose corticosteroids and avascular necrosis of the hip and knee. Pharmacoepidemiol Drug Saf 2000 9 187-91. [Pg.63]

Virik K, Karapetis C, Droufakou S, Harper P. Avascular necrosis of bone the hidden risk of glucocorticoids used as antiemetics in cancer chemotherapy. Int J Clin Pract 2001 55(5) 344-5. [Pg.63]

Braverman DL, Lachmann EA, Nagler W. Avascular necrosis of bilateral knees secondary to corticosteroid enemas. Arch Phys Med Rehabil 1998 79(4) 449-52. [Pg.68]

McLean CJ, Lobo RF, Brazier DJ. Cataracts, glaucoma, and femoral avascular necrosis caused by topical corticosteroid ointment. Lancet 1995 345(8945) 330. [Pg.93]

Avascular necrosis of the femoral head and another of slipped capital femoral epiphysis with avascular necrosis have been reported in two children with growth hormone deficiency receiving growth hormone (74). [Pg.512]

However, in a North American register of patients with chronic renal insufficiency and end-stage renal disease there was no excess of cases of slipped capital femoral epiphysis or avascular necrosis in those receiving growth hormone (75). [Pg.512]

Metabolic changes that protease inhibitors can cause after prolonged therapy include raised serum lactate, hypogonadism, hypertension and accelerated cardiovascular disease, reduced bone density, and avascular necrosis of the hip. Two large prospective studies in 1207 patients (972) and 3191 patients (973) have clarified the spectrum and incidence of metabolic changes in HAART and have explored the relative importance of protease inhibitors. In addition, data on fat redistribution from a postmarketing review of HIV-infected individuals taking indinavir have been published (974). [Pg.641]

This regimen was used by a bodybuilder who went through three cycles each year for 8 years.The subject also reported taking 600 mg of testosterone per week between cycles. This subject ultimately developed avascular necrosis in both femoral heads. [Pg.441]

Petrine KA. Association of anabolic steroids and avascular necrosis of femoral heads. Am J Sports Med. 1991 19 96-98. [Pg.457]

There is no cure for SLE. Guillermo el al. (G16) found only 10 randomized controlled trials during the past 5 years, 5 for lupus nephritis and 5 for all SLE patients. Compared to conventional therapies for lupus nephritis, a monthly bolus with intravenous cyclophosphamide is more effective than a monthly bolus with methyl prednisolone, but has significant side effects (including amenorrhea, cervical dysplasia, avascular necrosis, and herpes zoster) in both groups (G14). In order to avoid these side effects, more recent therapies have been developed. However, neither plasmapheresis (Wl), intravenous immunoglobulin (B21), recombinant human DNase (rhDNase) (D3), nor mycophenolate mofetil (C14) was shown to be more effective than conventional therapy. However, some of these... [Pg.132]

A man with severe hay fever who received at least one depot injection of corticosteroid each year for eleven years developed avascular necrosis of both femoral heads, an uncommon but serious complication of exposure to corticosteroid. Nasser SMS, Ewan P W 2001 British Medical Journal 322 1589. [Pg.556]

Stevens JM, Hilson AJ, Sweny P. Post-renal transplant distal limb bone pain. An under-recognized comphcation of transplantation distinct from avascular necrosis of bone Transplantation 1995 60(3) 305-7. [Pg.766]

In 539 patients with systemic lupus erythematosus, organ damage was associated with glucocorticoid therapy compared with controls (356). Oral prednisone 10 mg/day for 10 years (cumulative dose 36.6 g) was significantly associated with osteoporotic fractures (RR = 2.5 95% Cl = 1.7, 3.7), symptomatic coronary artery disease (RR = 1.7 Cl = 1.1, 2.5), and cataracts (RR = 1.7 Cl = 1.4, 2.5). Avascular necrosis was associated with high-dose prednisone (at least 60 mg/day for at least 2 months RR = 1.2 Cl = 1.1, 1.4). Intravenous pulses of methylprednisolone (1000 mg for 1-3 days) were associated with a small increase in the risk of osteoporotic fractures (RR = 1.3 Cl = 1.0, 1.8). [Pg.939]

Three patients developed unilateral or bilateral avascular necrosis of the femoral head after 3-54 months of treatment with interferon alfa for chronic myelogenous leukemia (314). One required bilateral hip replacement and two significantly improved after interferon alfa withdrawal. One patient received further interferon alfa without exacerbation. [Pg.1812]

Kozuch P, Talpaz M, Faded S, O Brien S, Freireich EJ, Kantarjian H. Avascular necrosis of the femoral head in chronic myeloid leukemia patients treated with interferon-alpha a synergistic correlation Cancer 2000 89(7) 1482-9. [Pg.1827]

Corticosteroids Hypertension, hyperglycemia, hyperlipidemia, hypokalemia, osteoporosis, avascular necrosis, cataract, weight gain, infections, fluid retention Blood pressure, bone densitometry, glucose, potassium, cholesterol, triglycerides (HDL, LDL) Polyuria, polydipsia, edema, shortness of breath, blood pressure, visual changes, bone pain Urinary dipstick for glucose every 3-6 months, total cholesterol yearly, bone densitometry yearly to assess osteoporosis... [Pg.1587]

Other calcium-containing crystals Monosodium urate monohydrate Neuropathic disorders Intra-articular corticosteroid overuse Avascular necrosis Bone dysplasia... [Pg.1687]


See other pages where Avascular necrosis is mentioned: [Pg.881]    [Pg.32]    [Pg.32]    [Pg.42]    [Pg.46]    [Pg.93]    [Pg.442]    [Pg.174]    [Pg.307]    [Pg.578]    [Pg.753]    [Pg.928]    [Pg.928]    [Pg.936]    [Pg.977]    [Pg.1286]    [Pg.1812]   
See also in sourсe #XX -- [ Pg.88 ]

See also in sourсe #XX -- [ Pg.3 , Pg.135 , Pg.153 , Pg.155 , Pg.199 , Pg.201 , Pg.204 , Pg.205 , Pg.221 , Pg.232 , Pg.233 , Pg.269 , Pg.288 , Pg.295 , Pg.351 ]




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