Annals of medicine · 2025
Prognostic analysis of steroid-induced osteonecrosis of the femoral head in children with immune kidney disease.
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Liu Jiao, Su Yuxi, Nan Guoxin
Аннотация
BACKGROUND: Glucocorticoid (GC) is the first-line treatment for immune kidney diseases; long-term or excessive use of GC can lead to steroid-induced osteonecrosis of the femoral head (SONFH). We analysed the clinical prognosis and associated factors of SONFH in children with immune kidney disease treated with GC.
MATERIALS AND METHODS: We conducted a retrospective analysis at our hospital between January 2012 and December 2022. Clinical data included sex, age, and body weight at the time of the first GC treatment, and GC dose associated with GC treatment. Hip joint function during the last follow-up was used as prognostic outcome. Participants were divided into poor (MDP hip score, <8 points) and medium-excellent groups (9-18 points), and nonparametric test and Spearman correlation analysis were performed.
RESULTS: We included 15 children with SONFH. The median age and weight at initial GC treatment were 12.67 (10.75, 14.83) years and 40.00 (37, 50) kg, respectively. The average follow-up time was 4.45 ± 2.54 years, and at last follow-up, 14 patients had bilateral SONFH Nonparametric tests revealed that age at initial GC treatment was older for children with poor hip joint scores (14.83 [12.5-16.4] years) than for those with medium-to-excellent scores (11.50 [10.5-13.8] years) (p = 0.05), and their first-month GC dose (0.127 [0.1-0.2] g) was also higher compared to that of medium-to-excellent group (0.081 [0.0-0.1] g) (p = 0.037); the differences were significant.
CONCLUSIONS: SONFH primarily manifests as bilateral onset, and the age at initial GC treatment and first-month GC dose were associated with hip joint prognosis of children with SONFH.
MATERIALS AND METHODS: We conducted a retrospective analysis at our hospital between January 2012 and December 2022. Clinical data included sex, age, and body weight at the time of the first GC treatment, and GC dose associated with GC treatment. Hip joint function during the last follow-up was used as prognostic outcome. Participants were divided into poor (MDP hip score, <8 points) and medium-excellent groups (9-18 points), and nonparametric test and Spearman correlation analysis were performed.
RESULTS: We included 15 children with SONFH. The median age and weight at initial GC treatment were 12.67 (10.75, 14.83) years and 40.00 (37, 50) kg, respectively. The average follow-up time was 4.45 ± 2.54 years, and at last follow-up, 14 patients had bilateral SONFH Nonparametric tests revealed that age at initial GC treatment was older for children with poor hip joint scores (14.83 [12.5-16.4] years) than for those with medium-to-excellent scores (11.50 [10.5-13.8] years) (p = 0.05), and their first-month GC dose (0.127 [0.1-0.2] g) was also higher compared to that of medium-to-excellent group (0.081 [0.0-0.1] g) (p = 0.037); the differences were significant.
CONCLUSIONS: SONFH primarily manifests as bilateral onset, and the age at initial GC treatment and first-month GC dose were associated with hip joint prognosis of children with SONFH.