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Osteonecrosis of the femoral head (OFH) is a progressive, debilitating disease that commonly leads to destruction of the hip joint. Most patients with OFH require surgery within a few years of onset (1). It has been shown that a variety of collagen diseases, such as systemic lupus erythematosus (SLE) and systemic vasculitis, are involved in the occurrence of non-traumatic OFH (2-5). Numerous reports have documented OFH after oral corticosteroid freatment. However, it is uncertain if corticosteroid freatment alone or in combination with other factors leads to the occurrence of OFH. Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS) is a severe drug reaction with multiple organ involvement (6,7). Oral corticosteroid is the first-line treatment for DIHS/DRESS. Recurrence is frequently observed during the course of the disease and may require long-term adminisfration of oral corticosteroids (7-9). We report here a case of OFH after prolonged oral corticosteroid therapy for dapsone-induced DIHS/DRESS in a young adult with Henoch-Schönlein purpura.

Osteonecrosis of the Femoral Head in a Patient with Henoch-Schönlein Purpura and Drug-induced Hypersensitivity Syndrome Treated with Corticosteroids