Osteonecrosis in Primary Antiphospholipid Syndrome is Associated with Previous Glucocorticoid Use and Thrombocytopenia

Jozélio Freire de Carvalho; Roberto Paulo Correia de Araujo; Thelma Larocca Skare

doi:10.1007/s40744-021-00333-9

Osteonecrosis in Primary Antiphospholipid Syndrome is Associated with Previous Glucocorticoid Use and Thrombocytopenia

Rheumatol Ther. 2021 Sep;8(3):1255-1261. doi: 10.1007/s40744-021-00333-9. Epub 2021 Jul 6.

Authors

Jozélio Freire de Carvalho¹, Roberto Paulo Correia de Araujo², Thelma Larocca Skare³

Affiliations

¹ Institute for Health Sciences, Federal University of Bahia, Rua das Violetas, 42, ap. 502, Pituba, Salvador, BA, Brazil. jotafc@gmail.com.
² Institute for Health Sciences, Federal University of Bahia, Rua das Violetas, 42, ap. 502, Pituba, Salvador, BA, Brazil.
³ Unit of Rheumatology, Hospital Evangélico Mackenzie, Curitiba, PR, Brazil.

Abstract

Introduction: The aim of this study was to investigate the frequency of avascular necrosis (AVN) and its associations with clinical and laboratory parameters in patients with primary antiphospholipid antibody syndrome (pAPS).

Methods: This was a cross-sectional study of 66 patients with pAPS who fulfilled the Sidney criteria for APS. Epidemiological and clinical data, and data on antiphospholipid antibodies were collected. Diagnosis of AVN was based on studies of magnetic resonance (MRI) images of affected bones.

Results: AVN was found in three of the 66 (4.5%) enrolled patients. Comparison of patients with pAPS with and without AVN showed that demographic data, comorbidities, and antiphospholipid antibodies profile were similar in both groups. Compared to patients without AVN, those with AVN had thrombocytopenia more frequently (66.7 vs. 7.9%) and used more glucocorticoids (100 vs. 35%).

Conclusion: AVN is rare in patients with pAPS and may be associated with thrombocytopenia and previous glucocorticoid use.

Keywords: Antiphospholipid antibodies; Antiphospholipid antibody syndrome; Osteonecrosis; Thrombosis.