Osteoporosis and fractures in systemic lupus erythematosus

Bultink, Irene E. M.

doi:10.1002/acr.20568

Cited by 105 publications

(97 citation statements)

References 56 publications

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“…Silva et al 13 showed that 68.3% of the celiac patients at the time of diagnosis had low BMD, 47% had osteopenia, and 32% had osteoporosis. Studying patients with SLE, Bultink 14 described the occurrence of bone changes in 68% of them. As for cystic fibrosis, another study 15 revealed a prevalence of 40 to 70% of bone alterations in adult patients.…”

Section: Discussionmentioning

confidence: 99%

Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease

Kotze

Costa

Cavassani

et al. 2017

Rev. Assoc. Med. Bras.

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Background: Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are characterized by chronic inflammation of the intestine that can reduce the absorption of nutrients such as vitamin D and calcium. Objective: To investigate bone alterations and serum levels of vitamin D in patients with IBD. Method: This was a cross-sectional study based on a review of medical records of patients from a private office in Curitiba, PR, Brazil. Serum levels of vitamin D and bone densitometry were measured at diagnosis of IBD. A total of 105 patients were included; 38 (58.4%) with CD; 27 (41.6%) with UC and 40 with irritable bowel syndrome (IBS) as comparison group. Results: When compared to patients with UC, CD patients showed a higher prevalence of bone alterations, being 15.8% with osteoporosis and 36.8% with osteopenia. In UC, bone alterations occurred in 29.6% of cases, 3.7% with osteoporosis and 25.9% with osteopenia. As for vitamin D levels, among CD patients, 10.5% had vitamin deficiency, 65.8% insufficiency and 23.7% were sufficient. In UC, 7.4% of cases had deficiency, 74.1% insufficiency and 18.5% had sufficient serum levels of vitamin D. In the group with IBS, deficiency was observed in 17.5% of cases, insufficiency in 55% and sufficiency in 27.5% of them. There was no significant difference between groups. Conclusion: IBD patients have a high prevalence of bone changes, especially those with CD. Serum levels of vitamin D are below the recommended in all the evaluated groups.

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Section: Discussionmentioning

confidence: 99%

Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease

Kotze

Costa

Cavassani

et al. 2017

Rev. Assoc. Med. Bras.

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“…Observational studies have unanimously demonstrated a higher risk of osteoporotic fracture in patients with SLE [9] . One of the largest observational studies found that there was a five-fold increase in fragility fracture occurrence in women with SLE when compared with the general population [10] .…”

Section: Fragility Fracturementioning

confidence: 99%

Orthopedic surgery and its complication in systemic lupus erythematosus

Mak¹

2014

WJO

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Systemic lupus erythematosus (SLE) is a multi-systemic immune-complex mediated autoimmune condition which chiefly affects women during their prime year. While the management of the condition falls into the specialty of internal medicine, patients with SLE often present with signs and symptoms pertaining to the territory of orthopedic surgery such as tendon rupture, carpal tunnel syndrome, osteonecrosis, osteoporotic fracture and infection including septic arthritis, osteomyelitis and spondylodiscitis. While these orthopedicrelated conditions are often debilitating in patients with SLE which necessitate management by orthopedic specialists, a high index of suspicion is necessary in diagnosing these conditions early because lupus patients with potentially severe orthopedic conditions such as osteomyelitis frequently present with mild symptoms and subtle signs such as low grade fever, mild hip pain and back tenderness. Additionally, even if these orthopedic conditions can be recognized, complications as a result of surgical procedures are indeed not uncommon. SLE per se and its various associated pharmacological treatments may pose lupus patients to certain surgical risks if they are not properly attended to and managed prior to, during and after surgery. Concerted effort of management and effective communication among orthopedic specialists and rheumatologists play an integral part in enhancing favorable outcome and reduction in postoperative complications for patients with SLE through thorough pre-operative evaluation, careful peri-operative monitoring and treatment, as well as judicious postoperative care.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: orthopedics; Complications; Surgery; Systemic lupus erythematosus; operation Core tip: Systemic lupus erythematosus (SLE) is a complex autoimmune condition. orthopedic specialists often encounter patients with SLE presenting with various orthopedic conditions which require surgical intervention but due to the complexity of SLE and its associated treatment, pre-operative preparation and post-operative care for these patients are often challenging. Concerted effort of management and effective communication between orthopedic specialists and rheumatologists play an integral part in enhancing favorable outcome and reduction in postoperative complications for patients with SLE through thorough preoperative evaluation, careful peri-operative monitoring and treatment, as well as judicious postoperative care.Mak A. Orthopedic surgery and its complication in systemic lupus erythematosus.

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“…Genel popülasyona benzer olarak SLE'li hastalarda yaş, postmenopozal durum, düşük vücut ağırlığı veya düşük vücut kitle indeksi, sigara ve alkol kullanımı osteoporoz için bağımsız risk faktörleridir. Çoğu SLE'li hastada osteoporoza yönelik, hastalıkla ilişkili ve geleneksel risk faktörleri birlikte görüldüğünden kemik kaybı erken başlangıçlı ve ilerleyici olarak görülür (51). Yapılan çoğu çalışma bayanlar üzerindedir, bu nedenle cinsiyetin KMY'ye olan etkisi netlik kazanmamıştır.…”

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Romatizmal Hastalıklarda Osteoporozun Etiyopatogenezi

Utine¹

2012

Tftr

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ÖzetRomatoid artrit, ankilozan spondilit, sistemik lupus eritematozus gibi enflamatuvar hastalıkların başta osteoporoz olmak üzere kas iskelet sistemi ile ilgili komplikasyonları mevcuttur. Bu hastalıklar enflamatuvar hastalıklarda yaygın olarak görülen azalmış fiziksel aktivite, beslenme bozukluğu, D vitamini eksikliği, kalsiyum alımında yetersizlik, glukokortikoid tedavisi gibi risk faktörlerinden bağımsız olarak osteoporoz ve artmış kırık riski ile ilişkilidir. Bu hastalıklarda görülen osteoporozun patogenezinde birçok faktör etkilidir. İmmün sistem ve kemik arasındaki ilişkilerin giderek anlaşılır hale gelmesi ile osteoimmünoloji kavramı önem kazanmıştır. Osteoklast, makrofaj koloni stimule edici faktör ve proenflamatuvar sitokinler enflamasyon ve osteoporoz arasındaki ilişkiyi açıklamaktadır. Bu derlemede amacımız romatoid artrit, ankilozan spondilit, sistemik lupus eritematozus gibi enflamatuvar hastalıklarda enflamatuvar kemik kaybının etiyopatogenezini güncel literatürler eşliğinde tartışmaktır. Türk Fiz T›p Re hab Derg 2012;58:319-25. Anahtar Kelimeler: Osteoporoz; enflamasyon; romatoid artrit; ankilozan spondilit; sistemik lupus eritematozus Sum maryVarious inflammatory diseases such as rheumatoid arthritis, ankylosing spondylitis and systemic lupus erythematosus are associated with musculoskeletal complications including osteoporosis. They are related to osteoporosis and increased risk of fractures independent of other risk factors like low physical activity, nutritional deficiency, hypovitaminosis D and inadequate calcium intake, as well as glucocorticoid treatment. The pathogenesis of osteoporosis in inflammatory diseases is multifactorial. The concept of osteoimmunology is based on growing insights into the relationship between the immune system and bone. The association between inflammation and osteoporosis can be explained by the link between osteoclast, macrophage colony stimulating factor and proinflammatory cytokines. Here we discuss the etiopathogenesis underlying the inflammatory loss of bone in rheumatoid arthritis, ankylosing spondylitis and systemic lupus erythematosus. Turk J Phys Med Re hab 2012;58:319-25. Key Words: Osteoporosis; inflammation; rheumatoid arthritis; ankylosing spondylitis; systemic lupus erythematosus GirişEklem enflamasyonu ile seyreden romatizmal hastalıklar, başta osteoporoz olmak üzere kas iskelet sistemi ile ilgili komplikasyonlara neden olmaktadır. Kemik dokusu sürekli yapım ve yıkıma uğrayan dinamik bir dokudur, kronik enflamasyon bu süreci etkileyerek kemik kaybına yol açabilir. Romatizmal hastalıklarda enflamasyonun kontrolü, yapısal kemik hasarını ve kemik kaybını azaltmaktadır. Romatoid artrit (RA), ankilozan spondilit (AS) ve sistemik lupus eritematozus (SLE) gibi enflamatuvar romatizmal hastalıklarda; osteoklast, makrofaj koloni stimülan faktör (M-CSF) uyarıcı faktör ve özellikle tümör nekroz faktörü-alfa (TNF-alfa) ve interlökin-1 (IL-1) gibi proenflamatuvar sitokinlerin arasındaki bağlantı enflamasyon ve osteoporoz arasındaki ilişkiyi göstermektedir. Bu ...

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Osteoporosis and fractures in systemic lupus erythematosus

Cited by 105 publications

References 56 publications

Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease

Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease

Orthopedic surgery and its complication in systemic lupus erythematosus

Romatizmal Hastalıklarda Osteoporozun Etiyopatogenezi

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