The effect of long‐term methylprednisolone treatment on the femoral head in growing pigs

Abstract

The efTect of long term steroid treatment on coagulation, intraosseous pressure (IOP), femoral head (FH) blood flow, and histology in the normal organism was investigated in this study in growing pigs. From 24 growing female Danish Landrace pigs from 12 litters, 12 animals daily received 100 nig methylprednisolone orally for three months. Their 12 sister pigs served as controls without steroid treatment. Prothrombin time, activated partial thromboplastin time (aPTT), fibrinogen, and antithrombin 111 levels were recorded in jugular venous blood. Blood flow of the hip regions was measured by means of the radioactive microsphere technique. Metaphyseal and epiphyseal IOP of the left or right proximal femur were measured. Histomorphometry of the left or right FH epiphysis was performed. Major growth inhibition was found in the corticosteroid (CS) treated group. In CS pigs, aPTT was shortened to 500'0 compared to control pigs. Plasma fibrinogen was higher in the CS animals. Total F H blood flow was not digerent while regional blood flow in the cranial subregion of the F H epiphysis was higher in the CS group. Metaphyseal and epiphyseal 1OP of the proximal femur were not different in the CS animals. Histomorphometrically, cancellous bone volume

Femoral head blood flow reduction and hypercoagulability under 24 h megadose steroid treatment in pigs

“…Nevertheless, bone blood flow remained unchanged throughout the experiment in the control group of pigs in all osseous regions measured (Table 2) which appears to be due to the ability of bone to autoregulation of blood flow [l 11. Comparison of blood flow data from the present study in awake pigs with those from a previous study in anesthetized pigs reveals a more homogenous perfusion of the osseous hip regions in the awake animal [7]. No difference was found in FH epiphyseal blood flow (Table 2) which was a mean 13.2 m1/100 g/min in anesthetized pigs.…”

“…Belgium) in phases l and 3. The samples were centrifuged for 10 min at 4000 cycleslmin at 4 "C temperature [7]. Using platelet free plasma, the prothrombin time (PT; thromboplastin reagent Excel S, Organon Teknika, Ttirnhout.…”

“…Intravascular coagulation based on the hypercoagulable state may be the pathomechanism for the FH blood flow reduction observed in the present study. In a previous study, we found hypercoagulability and segmental F H ossification defects in 3 months methylprednisolone treated pigs [7]. Intravascular aggregations of fibrin clots mainly on the venous side of the femoral head vascular system have been found in necrotic human femoral heads [29].…”

“…The effect of such treatment on F H blood flow and plasma coagulability, and especially the time pattern of changes has not yet been investigated. Femoral head blood flow was 2-3 fold lower after 2 week high dose steroid treatment [S], and hypercoagulability of plasma was found after 3 months of steroid treatment in pigs in previous studies [7].…”

Efficacy of methylprednisolone pulse therapy in steroid-resistant nephrotic syndrome

“…There are many reports of hypercoagulability associated with the nephrotic syndrome with frequent thromboembolic complications [10,11,12,13]. However, there are many reports that MPT may affect the anticoagulant system [14,15,16,17,18]. Therefore, we added heparin to MPT for anticoagulation, which prolonged the activated partial thromboplastin time before starting of MPT.…”