Multifocal Osteonecrosis and Guillain Barré Syndrome
DOI:
https://doi.org/10.25759/spmfr.258Keywords:
Guillain-Barre Syndrome, OsteonecrosisAbstract
Multifocal osteonecrosis, defined by the involvement of 3 or more anatomic sites, is unusual, being observed in only 3% to 11% of patients diagnosed with osteonecrosis. Guillain– Barré syndrome is an acute onset, usually monophasic immune-mediated disorder of the peripheral nervous system.
The aim of this article is to report a clinical case of multifocal osteonecrosis and Guillain–Barré syndrome with review of the literature.
We present a case of a 40-year-old male, with neurological symptoms who presented to the Emergency Department one week after a flu like syndrome. Myelitis was firstly suspected and corticosteroids were started. Diagnosis of Guillain–Barré syndrome was later confirmed and he underwent treatment with immunoglobulins. One year later, the patient developed bilateral hips and shoulders arthralgia. The diagnosis of multifocal osteonecrosis was established by magnetic resonance imaging. Total right hip arthroplasty was performed and a left one was planned. The patient underwent a rehabilitation program aiming pain relief and function improvement with a good outcome.
In the last ten years literature review, there were no reports of the association between Guillain–Barré syndrome and multifocal osteonecrosis.
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References
Lykissas MG, Gelalis ID, Kostas-Agnantis IP, Vozonelos G, Korompilias AV. The role of hypercoagulability in the development of osteonecrosis of the femoral head. Orthop Rev. 2012;4:e17.
Hirota Y, Hirohata T, Fukuda K, Mori M, Yanagawa H, Ohno Y, et al. Association of alcohol intake, cigarette smoking, and occupational status with the risk of idiopathic osteonecrosis of the femoral head. Am J Epidemiol. 1993;137:530-8.
Shim K, MacKenzie MJ, Winquist E. Chemotherapy-associated osteonecrosis in cancer patients with solid tumours: a systematic review. Drug Saf. 2008;31:359-71. doi: 10.2165/00002018-200831050-00001.
Akinyoola AL, Adediran IA, Asaleye CM, Bolarinwa AR. Risk factors for osteonecrosis of the femoral head in patients with sickle cell disease. Int Orthop. 2009;33:923-6. doi: 10.1007/s00264-008-0584-1.
LaPorte DM, Mont MA, Mohan V, Jones LC, Hungerford DS. Multifocal osteonecrosis. J Rheumatol. 1998;25:1968-74.
Glueck CJ, Freiberg RA, Boppana S, Wang P. Thrombophilia, hypofibrinolysis, the eNOS T-786C polymorphism, and multifocal osteonecrosis. J Bone Joint Surg Am. 2008;90:2220-9. doi: 10.2106/JBJS.G.00616.
Hughes RA, Swan AV, van Koningsveld R, van Doorn PA. Corticosteroids for Guillain-Barre syndrome. Cochrane Database Syst Rev. 2006:Cd001446.
Symptomatic multifocal osteonecrosis. A multicenter study. Collaborative Osteonecrosis Group. Clin Orthop Relat Res. 1999:312-26.
Zhang NF, Li ZR, Wei HY, Liu ZH, Hernigou P. Steroid-induced osteonecrosis: the number of lesions is related to the dosage. J Bone Joint Surg Br. 2008;90:1239-43.
Flouzat-Lachaniete CH, Roussignol X, Poignard A, Mukasa MM, Manicom O, Hernigou P. Multifocal joint osteonecrosis in sickle cell disease. Open Orthop J. 2009;3:32-5.
[Guideline] American College of Radiology. ACR Appropriateness Criteria® avascular necrosis (osteonecrosis) of the hip. National Guideline Clearinghouse. [Accessed: September 18, 2017]. Available at: http://guideline.gov/content.aspx?id=15734&search=avascular+necrosis
Mont MA, Ulrich SD, Seyler TM, Smith JM, Marker DR, McGrath MS, et al. Bone scanning of limited value for diagnosis of symptomatic oligofocal and multifocal osteonecrosis. J Rheumatol. 2008;35:1629–34.
Awais M, Hafeez S, Rehman A, Baloch NU. Vibration-induced multifocal carpal osteonecrosis in a 31-year-old man. Occup Environ Med. 2015;72:684. doi: 10.1136/oemed-2015-103100.
Gomez-Puerta JA, Peris P, Reverter JC, Espinosa G, Martinez-Ferrer A, Monegal A, et al. High prevalence of prothrombotic abnormalities in multifocal osteonecrosis: description of a series and review of the literature. Medicine . 2013;92:295-304. doi: 10.1097/MD.0000000000000007.
Stroh DA, LaPorte DM, Marker DA, Johnson AJ, Mont MA. Atraumatic osteonecrosis of the distal radius and ulna: case series and review. J Hand Surg Am. 2012;37:134-41. doi: 10.1016/j.jhsa.2011.09.028.
Galindo M, Mateo I, Pablos JL. Multiple avascular necrosis of bone and polyarticular septic arthritis in patients with systemic lupus erythematosus. Rheumatol Int. 2005;25:72-6.
Fajardo-Hermosillo LD, Lopez-Lopez L, Nadal A, Vila LM. Multifocal osteonecrosis in systemic lupus erythematosus: case report and review of the literature. BMJ Case Rep. 2013;2013. doi: 10.1136/bcr-2013-008980.
Ibanez D, Martin MD, Rubio RA, Muel C. Multifocal osteonecrosis in longterm corticoid treatment secondary to panhypopituitarism: a case report. Endocrinol Nutr. 2013;60:416-8.
Solarino G, Scialpi L, Bruno M, De Cillis B. On a case of multifocal osteonecrosis in a patient suffering from acute lymphoblastic leukemia. Chir Organi Mov. 2008;92:119-22.
Gonzalez Garcia A, Sifuentes Giraldo WA, Blazquez Canamero MA, Ahijon Lana M, Navas Elorza E, Vazquez Diaz M. Multifocal osteonecrosis associated with human immunodeficiency virus infection. Reumatol Clin. 2012;8:361-4. doi: 10.1016/j.reuma.2012.01.008.
Akinyoola AL, Adediran IA, Oginni LM, Onayemi O. Multifocal osteonecrosis in HIV/AIDS: a case report. West Afr J Med. 2006;25:82-3. 22. Mundo J, Peris P, Monegal A, Navasa M, Cervera R, Guaniabens N. Multifocal avascular necrosis after liver transplantation: an unusual presentation of the antiphospholipid syndrome. Lupus. 2006;15:304-7.
Sinclair V, Shepard G. Symptomatic, steroid-induced, multifocal diaphyseal osteonecrosis in a patient with multiple sclerosis. Mult Scler. 2010; 16(3):370-2.
Castro TC, Lederman H, Terreri MT, Kaste SC, Hilario MO. Detection of multifocal osteonecrosis in an adolescent with dermatomyositis using whole-body MRI. Pediatr Radiol. 2010;40:1566-8. doi: 10.1007/s00247-010-1636-4.
Cavallasca JA, Laborde HA, Araujo MB, Nasswetter GG. Multiple avascular necrosis in a patient with systemic lupus erythematosus/systemic sclerosis overlap syndrome. Clin Rheumatol. 2005;24:406-8.
Garcia-Miguel J, Calvet-Fontova J, Maymo-Guarsch J, Carbonell-Abello J. Osteonecrosis multifocal en un paciente con lupus eritematoso sistemico. Med Clin. 2006;127:276.
Salesi M, Karimifar M, Mottaghi P, Sayedbonakdar Z, Karimzadeh H. A case of SLE with bilateral osteonecrosis of femoral heads and bone infarct in distal of femur. Rheumatol Int. 2010;30:527-9. doi: 10.1007/s00296-009-0956-x
Robinson AB, Rabinovich CE. Avascular necrosis of the metacarpals in juvenile dermatomyositis. J Clin Rheumatol. 2010;16:233-6. doi: 10.1097/RHU.0b013e3181e9345d.
Grunert PC, Collettini F, Perka C, Zeitz M, Wiedenmann B, Buning C. A rare cause of peripheral arthralgia in inflammatory bowel disease: multifocal osteonecrosis. Z Gastroenterol. 2014;52:285-9. doi: 10.1055/s-0034-1365933.
Ziskoven C, Richter J, Patzer T, Kircher J, Krauspe R. Joint failure after steroid therapy in tuberculous encephalitis. Scand J Infect Dis. 2014;46:533-6.
Roach R, Miller D, Griffiths D. Multifocal osteonecrosis predominantly affecting the knees secondary to chronic alcohol ingestion: A case report and review. Acta Orthop Belg. 2006;72:234-6. doi: 10.3109/00365548.2014.898334.
Moon JG, Shetty GM, Biswal S, Shyam AK, Shon WY. Alcohol-induced multifocal osteonecrosis: a case report with 14-year follow-up. Arch Orthop Trauma Surg. 2008;128:1149-52. doi: 10.1007/s00402-007-0563-9.
Rostom S, Bahiri R, Hajjaj-Hassouni N. Multifocal avascular necrosis revealing antiphospholipid syndrome. Clin Rheumatol. 2008;27:271-2.
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