Shapiro S C, Rothstein F C, Newman A J, Fletcher B, Halpin T C
J Pediatr Gastroenterol Nutr. 1985 Jun;4(3):502-6. doi: 10.1097/00005176-198506000-00031.
Three adolescents with severe Crohn's ileocolitis developed osteonecrosis after receiving intravenous corticosteroids and parenteral nutrition, including 10% lipid infusion. Each had achieved clinical remission with therapy. However, several months following completion of therapy, each developed arthralgias and arthritis of weight-bearing and non-weight-bearing joints. Roentgenographic evaluation revealed osteonecrosis involving multiple joints. Osteonecrosis may result from the interference with blood flow to bone and has been produced in animals by infusion of lipid solutions and administration of corticosteroids. We report these cases of osteonecrosis as a probable complication of corticosteroid and lipid infusion in adolescents treated for severe Crohn's disease.
三名患有严重克罗恩病性回结肠炎性的青少年在接受静脉注射皮质类固醇和肠外营养（包括输注10%脂肪乳剂）后发生了骨坏死。每名患者经治疗后均实现了临床缓解。然而，在治疗结束数月后，每名患者均出现了负重和非负重关节的关节痛和关节炎。X线评估显示多个关节发生了骨坏死。骨坏死可能是由于流向骨骼的血流受到干扰所致，并且在动物实验中通过输注脂质溶液和给予皮质类固醇已诱发了骨坏死。我们报告这些骨坏死病例，认为这可能是重度克罗恩病青少年患者接受皮质类固醇和脂质输注治疗后的一种并发症。
