Osteoporosis and systemic lupus erythematosus: etiology and treatment strategies.

The importance of bone loss in patients with systemic lupus erythematosus can not be over emphasized. Risk factors for osteoporosis in these patients include not only those that apply to the general population, but also many that are related to the underlying disease process, or its treatment. Ongoing research should attempt to clarify the prevalence of low bone mass in lupus, as well as the pathogenic mechanisms applying especially to this population. Strategies for the prevention and treatment of bone loss in lupus patients do not differ significantly from those in the general population. Special attention must be given to the prevention of steroid induced bone loss, as well as to the gonadal effects of cytotoxic agents.