Uittenbogaart C H, Isaacson A S, Stanley P, Pennisi A J, Malekzadeh M H, Ettenger R B, Fine R N
Am J Dis Child. 1978 Aug;132(8):765-7. doi: 10.1001/archpedi.1978.02120330037009.
Aseptic necrosis developed in 11 (6%) of 171 recipients of renal allografts who underwent transplant operations at Childrens Hospital of Los Angeles between February 1967 and August 1977. Pain was the predominant presenting symptom and preceded roentgenographic evidence of aseptic necrosis by as long as seven months. Initial symptoms occurred two months to four years posttransplant. Limited weight bearing and reduction in the dosage of prednisone failed to prevent the progressive destruction of five femoral heads in three patients. Hip replacement led to an amelioration of the symptoms and a resumption of normal activity in each patient. Two patients with involvement of multiple osseous structures have persistent knee and elbow joint pain and effusions, and one of them has required prosthetic replacement of the proximal humerus. No therapy was required for patients with aseptic necrosis of single bones of the hand and foot. There was no statistically significant difference in the total steroid dose received during the first posttransplant year between patients in whom aseptic necrosis developed, and those in whom it did not develop.
1967年2月至1977年8月期间，在洛杉矶儿童医院接受肾移植手术的171例肾移植受者中，有11例（6%）发生了无菌性坏死。疼痛是主要的首发症状，在X线显示无菌性坏死迹象之前长达7个月就已出现。初始症状出现在移植后2个月至4年。3例患者的5个股骨头出现进行性破坏，限制负重和减少泼尼松剂量未能阻止这种情况。髋关节置换使每位患者的症状得到改善并恢复了正常活动。2例累及多个骨结构的患者持续存在膝关节和肘关节疼痛及积液，其中1例需要进行肱骨近端假体置换。手足单骨无菌性坏死的患者无需治疗。发生无菌性坏死的患者与未发生无菌性坏死的患者在移植后第一年接受的总类固醇剂量上没有统计学显著差异。
