{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:16:19Z","timestamp":1783008979680,"version":"3.54.5"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore risk factors for developing osteonecrosis in patients with systemic lupus erythematosus (SLE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty-six SLE patients with osteonecrosis from January 2018 to December 2019 were described. Fifty SLE patients without osteonecrosis were selected as controls from the SLE database (total 2,680) of our hospital during the same period. Clinical manifestations and laboratory tests were recorded and analyzed, especially antibodies. Univariate and multivariate analyses were used to evaluate possible associated risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-six (3 male, 23 female) SLE patients with osteonecrosis were confirmed by X-ray and magnetic resonance imaging. The median course from SLE onset to osteonecrosis onset was 45 (range 2\u2013302) months. Seven (27%) patients had a single joint involved and 19 (73%) patients had two or more joints involved. Besides, the incidence of femoral head osteonecrosis (FHON), knee ON, and humerus head ON were 85% (22\/26), 27% (7\/26), and 12%(3\/26), respectively. The multivariate logistic regression analysis showed that the score of European Consensus Lupus Activity Measurement (ECLAM) at SLE onset [odds ratio (OR) 1.37; 95% confidence interval (CI) 1.07\u20131.75], a cumulative dose of prednisone above 10 g (OR 15.49; 95% CI 3.38\u201384.61), and positive of independent anti-RNP antibodies (OR 3.35; 95% CI 0.80\u201310.73) were significantly associated with osteonecrosis in SLE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The score of ECLAM at SLE onset, a cumulative dose of prednisone above 10 g, and positive anti-RNP antibodies are associated with osteonecrosis in SLE. Herein, we reported for the first time that anti-RNP antibodies were associated with osteonecrosis in SLE patients and might be a novel predictor.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.847875","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T04:35:45Z","timestamp":1649651745000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Anti-RNP Antibody: A Potential Novel Predictor for Osteonecrosis in Systemic Lupus Erythematosus"],"prefix":"10.3389","volume":"9","author":[{"given":"Jiangbiao","family":"Xiong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujiao","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"B1","first-page":"2226","article-title":"Outcomes of symptomatic osteonecrosis in 95 patients with systemic lupus erythematosus","volume":"28","author":"Gladman","year":"2001","journal-title":"J Rheumatol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1001\/jama.1960.03030080028005","article-title":"Avascular (aseptic) bone necrosis associated with systemic lupus erythematosus","volume":"174","author":"Dubois","year":"1960","journal-title":"JAMA."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1093\/rheumatology\/ker277","article-title":"Incidence of osteonecrosis associated with corticosteroid therapy among different underlying diseases: prospective MRI study","volume":"50","author":"Shigemura","year":"2011","journal-title":"Rheumatology (Oxford)."},{"key":"B4","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1177\/0961203307076771","article-title":"Disease activity as a major risk factor for osteonecrosis in early systemic lupus erythematosus","volume":"16","author":"Fialho","year":"2007","journal-title":"Lupus."},{"key":"B5","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1097\/RHU.0b013e3181ba3423","article-title":"Factors associated with osteonecrosis in Thai lupus patients: a case control study","volume":"15","author":"Uea-areewongsa","year":"2009","journal-title":"J Clin Rheumatol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1177\/0961203317711012","article-title":"Osteonecrosis in SLE: prevalence, patterns, outcomes and predictors","volume":"27","author":"Gladman","year":"2018","journal-title":"Lupus."},{"key":"B7","first-page":"761","article-title":"Predictive factors for symptomatic osteonecrosis in patients with systemic lupus erythematosus","volume":"28","author":"Gladman","year":"2001","journal-title":"J Rheumatol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1007\/s00296-010-1597-9","article-title":"Risk factors for avascular bone necrosis in patients with systemic lupus erythematosus","volume":"32","author":"Sayarlioglu","year":"2012","journal-title":"Rheumatol Int."},{"key":"B9","doi-asserted-by":"publisher","first-page":"15563","DOI":"10.1038\/s41598-020-71923-w","article-title":"Epidemiology and risk factors for avascular necrosis in childhood systemic lupus erythematosus in a Taiwanese population","volume":"10","author":"Tsai","year":"2020","journal-title":"Sci Rep."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2677","DOI":"10.1002\/art.34473","article-title":"Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus","volume":"64","author":"Petri","year":"2012","journal-title":"Arthritis Rheum."},{"key":"B11","first-page":"541","article-title":"Disease activity in systemic lupus erythematosus: report of the Consensus Study Group of the European Workshop for Rheumatology Research. 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