ALEXANDRU PATRASCU, LILIANA SAVIN, OLIVERA LUPESCU, DAN MIHAILESCU, DANA NICOLETA MIHAI, MARIUS NECULAES, VICTOR GRIGORESCU, CARMEN GREIEROSU, PAUL BOTEZ MULTIFOCAL OSTEONECROSIS GLUCOCORTICOID INDUCED
The present study describes a 29 years old patient diagnosed with aseptic osteonecrosis with multiple localization occurred after a corticoid treatment for chronic toxic hepatitis. The clinical and para-clinical examinations determined the diagnosis of Wilson disease and avascular necrosis with multiple localizations. The evolution of the disease was favourable following the surgical treatment consisting of bilateral total hip arthroplasty with cementless prosthesis, hemi-arthroplasty of the left shoulder with cementless prosthesis, orthotopic hepatic transplantation with an entire liver from donor in cerebral death and immunosuppressive, anticoagulant, antiretroviral and gastro-protective treatment. There is an increase of the number of patients undergoing a glucocorticoids treatment for several months, years or lifelong periods. This type of treatment increases the risk of osteonecrosis depending on the dosage and the duration of the treatment.
Keywords: aseptic necrosis, arthroplasty, corticoid therapy, Wilson disease