Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of total hip arthroplasty for femoral head necrosis while using satralizumab for neuromyelitis optica spectrum disorders

Manabu Inoue, M,D., Ph.D.1), Shingo Maeda, M.D.2) and Hirotsugu Ohashi, M.D., Ph.D.2)

1) Department of Neurology, Osaka Saiseikai Nakatsu Hospital
2) Department of Orthopaedic Surgery, Osaka Saiseikai Nakatsu Hospital

A 47-year-old woman developed right femoral head necrosis during long-term steroid use for neuromyelitis optica spectrum disorder. She underwent a total hip arthroplasty because her right hip pain persisted after satralizumab treatment. There were no postoperative infections. Under oral administration of tacrolimus 3 mg, prednisolone 11 mg, and acetaminophen 2,275 mg, her postoperative body temperature was less than 38°C and normalized in about 2 days after the operation. No parameters indicating worsening of inflammation were observed in the blood test. In satralizumab-treated patients, infection cannot be ruled out even without inflammatory findings. In particular, if a slight fever of the 37°C-range or a mildly high white blood cell count persists, paying attention to signs of infection and actively investigating the presence or absence of infection using medical image diagnostic devices are necessary.
Full Text of this Article in Japanese PDF (869K)

(CLINICA NEUROL, 63: 592|595, 2023)
key words: satralizumab, biologics, neuromyelitis optica spectrum disorders, femoral head necrosis, total hip arthroplasty

(Received: 20-Apr-23)