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Year : 2014  |  Volume : 27  |  Issue : 3  |  Page : 556-561

Study of bone mineral density in patients with systemic lupus erythematosus

1 Department of Internal Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Physical Medicine and Rehabilitation Unit, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Enas Sobhei Zahran
Department of Internal Medicine, Faculty of Medicine, Menoufia University, Shebin Al-Kom, Menoufia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-2098.145512

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Objective The aim of the study was to investigate bone mineral density (BMD) in systemic lupus erythematosus (SLE) patients, either newly diagnosed or treated. Background As a consequence of the chronic course of SLE, osteoporosis can be a further clinical challenge in these patients. SLE-related medications can increase bone turnover, which eventually weakens bone architecture, and subsequently reduces bone strength and increases the risk for fractures, but there is good evidence that the disease per se can lead to reduced bone mass through several mechanisms such as reduced motility, renal impairment, and the systemic effect of bone-resorbing cytokines. Materials and methods In this study, we examined 30 lupus patients diagnosed with SLE. Patients were divided into two groups. Group II included 15 newly diagnosed patients and group III included 15 treated lupus patients. Patients diagnosed with SLE met four or more criteria of the American College of Rheumatology (ACR) for SLE. SLE Disease Activity Index (SLEDAI) and SLE International Collaboration Clinics/ACR (SLICC/ACR) index were calculated for all patients. Ten healthy adults were included as the control group (group I). Dual-energy X-ray absorptiometry was performed in all studied patients in addition to routine investigations. Results The total patient number was 30. Ninety-three percent of patients were female and in the age group of 17-30 years. There was a significant reduction in BMD in diagnosed lupus patients (groups II and III) compared with healthy adults of the same age and sex. Forty percent of newly diagnosed lupus patients had osteopenia. Sixty percent of treated patients had osteopenia and 20% had osteoporosis. There was no difference among lupus patients with low BMD as regards steroid dose, SLEDAI, and SLICC/ACR index. Conclusion BMD was reduced in SLE patients as compared with healthy age-matched and sex-matched controls. It decreased in both newly diagnosed (40%) and treated lupus patients (80%). BMD in lupus patients was not affected by the duration of disease, corticosteroid doses, or SLEDAI and SLICC/ACR index.

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