SARS treatment causes joint disease
Treatment for severe acute respiratory syndrome (SARS) causes joint disease, according to a new study published in the Journal of Bone and Joint Surgery –British Volume.
Researchers conducted a review of more than 100 patients who were treated with corticosteriods for SARS during the first outbreaks in China in 2003.
They found that nearly 40 per cent went on to develop osteonecrosis, which is caused when blood supply to the bones is reduced or cut off completely, resulting in the death of the bone.
This is the first time that a causal link between the amount of steroid given and the severity of joint disease has been positively established.
Osteonecrosis can be serious when it affects the hip, knee, shoulder or ankle, and in later stages can mean total joint replacement.
"The number of osteonecrotic lesions was directly related to the dosage of steroids and that a very high dose, a peak dose of more than 200 mg or a cumulative methylprednisolone-equivalent dose of more than 4000 mg, is a significant risk factor for multifocal osteonecrosis with both epiphyseal and diaphyseal lesions," the study authors concluded.
They recommended that in future SARS patients should be treated with lower doses of steroids, since the number of osteonecrotic lesions was directly related to the dosage.
A spokeswoman for the Arthritis Research Campaign said the link between high steroid dosage and the development of osteonecrosis was surprising in SARS patients.
"We know that high dose steroids can cause osteoporosis, but obviously these drugs have other, previously unknown effects," she added.
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