LEVELS OF LIVER ENZYMES, AND SERUM LIPIDS, AND ITS ASSOCIATION WITH FEMORAL HEAD OSTEONECROSIS AFTER CORTICOSTEROID TREATMENT IN EGYPTIEN LUPUS PATIENTS.

Objective; to evaluate the association of liver enzymes and serum lipids levels with femoral head osteonecrosis in active SLE patients after high dose steroid treatment. Methods; Fifty four active SLE patients aged 19-50 years, (7 men and 47 women) were included in our study. Patients were given 40-80 mg prednisolone /day, except 9 patients were treated with 1,000 mg/day for 3 days . Patients are followed immediately before starting steroid therapy, and then at 1, 2 and 3 months as regard clinical ,and laboratory variables including liver enzymes and serum lipids. Patients were classified into ONF group and non-ONF group based on MRI findings.The ONF group included 2 men and 15 women, aged 19-50 years. The non-ONF group included 5 men and 32 women, aged 22-49 years. Results; There was non significant difference between ONF and non-ONF groups as regard total SLEDAI, ALT, AST, GGT, LDH, TC, HDLP, LDLP ,and TG after follow up at one month. At second month non significant difference was found between ONF and non-ONF groups as regard total SLEDAI, ALT, AST, GGT,and LDH while there was significant difference between ONF and non-ONF groups as regard TC,HDLP, LDLP,and TG. The same findings were present at third month .The prevalence of ONF in our patients were found to be 31% and most of the cases were detected in the second month. Conclusion; SLE patients who developed ONF showed significant increase in levels of serum lipids, however, no increase in liver enzymes was found over three months of follow up after increasing steroid dose.