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Crohn's Disease Forum » Treatment » Imuran/Azathioprine/6-MP » Aza and osteonecrosis of the femoral head


10-20-2013, 02:50 AM   #1
jonathanzn
 
Join Date: May 2012
Location: Nanjing, China
Aza and osteonecrosis of the femoral head

Hi everybody,

I have had prednisone for five months last year from April to October, then in November 22th I toke my first surgeory. The dose of prednisone is about twice 40mg down to 0. And from May last year, I began taking Imuran 2 pills/day until now.

About 2 or 3 months ago, I found that my left knee was hurting. Now after taking MRI and X RAY of my knee and hip, I have got seriously osteoporosis and even femoral head necrosis. I am only 29!!!

The doctors said that the main reason was prednisone, but i have ceased it for 1 year. I'm cercern that Imuran is another main reason.

I don't find any evidence about Imuran or Aza could take OP. But i am worry that Imuran/Aza could interfer/hamper the regeneration of the bones because of its bone marrow suppression sideeffect.

So, could u help me about my worry? thx!
10-20-2013, 09:24 AM   #2
Aussie
Senior Member
 
Join Date: Jun 2010
Location: Brisbane, Queensland, Australia
Hi Jonathon, to understand the situation, you'll need to look at bone anatomy.

The outside of the bone is called cortical bone, is hard, and when the density decreases you get osteopenia and then osteoporosis. One of the most common causes is prednisone.

In the middle of (long) bones is the bone marrow, this is where you find the blood cells being formed. Imuran, if dosed too high, can cause bone marrow suppression, which will lead to decreased blood cells, particularly white blood cells, but will have zero effect on the cortical bone.

So, no the imuran would not of caused the osteoporosis, the steroids would have - and the role of imuran is the prevent further courses of steroids (steroid-sparing agent) so definitely worth staying on it.

Best wishes.
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Crohn's Disease Forum » Treatment » Imuran/Azathioprine/6-MP » Aza and osteonecrosis of the femoral head
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