The Lupus/Osteoporosis Connection
What is one side effect of using cortisone or prednisone?
Hi I'm Dr. Bob Lahita for About.com and I'm Chairman of Medicine at Newark Beth Israel Medical Center, part of Barnabas Health and Professor of Medicine at UMDNJ in Newark, New Jersey. I'm going to talk to you about lupus and osteoporosis.First let me explain that lupus erythematosus is an autoimmune disease which is a systemic disease involving the entire body. It is generally a disease which is treated by the use of immunosuppressants. Now I should say also, at the outset, that this is a disease that involves predominantly women although there are many men that have systemic lupus. It is a disease of women in the child-bearing years, but it can affect both men and women at any time in their lives.Now that is important when we are talking about osteoporosis which is basically the loss of the skeleton, or the matrix, or the substance of bone in the body. Bone is made up of a number of different things, a matrix, sort of a skeleton within a skeleton that holds calcium and phosophorus together to make bones very, very strong. But Osteopenia means the bleaching of calcium from the bone and osteopenia by itself needs to be treated by your doctor, but osteoporosis is a couple of steps further, it is actual loss of bone and weakening of bone. And this can result in fractures of bone.Now what does that have to do with Lupus? Well it has to do with the fact that when we treat patients with lupus we often use cortisone or prednisone. And one of the side effects of cortisone or prednisone is bleaching of bone, loss of calcium in the bone, destruction of the bone. What happens is your bones become very, very brittle. They become very, very soft – sort of like a hard form of cardboard.And because the bones are so soft, the tendency is to have breakage of those bones. What we call pathologic fractures: this means that the bones break by themselves or with minimal stress. Such and example might be a young woman who's been on prednisone for years to treat her Lupus who has been hugged by her child, and all of a sudden three ribs are broken. And this is not an uncommon thing.So, that's the connection between lupus and osteoporosis. It's easy to treat osteoporosis - there are many, many drugs, not the least of which are Vitamin D which is by the way often low in patients with lupus – addition of calcium. And then there are other drugs which are brand new that are injectable – various hormones that can strengthen the bones and make your skeleton a lot harder.So for About.com – where you can go on the web and see more about systemic lupus – I want to thank you.