Osteonecrosis and Thrombophilia: Pathophysiology, Diagnosis, and Treatment
| Autor: | Charles J. Glueck, Richard A. Freiberg, Ping Wang |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty business.industry 030204 cardiovascular system & hematology medicine.disease Thrombophilia Gastroenterology Pathophysiology Loss of heterozygosity 03 medical and health sciences 0302 clinical medicine Coagulation Internal medicine Coagulation testing medicine Factor V Leiden Factor V Leiden mutation business Testosterone |
| Zdroj: | Osteonecrosis of the Femoral Head ISBN: 9783319506623 |
| Popis: | We describe three patients: two women, ages 47 and 69, and a man, age 54, with Ficat stages I, II, and I–II primary osteonecrosis at entry. Coagulation tests revealed heterozygosity for the G20210A prothrombin gene mutation, resistance to activated protein C, and heterozygosity for the factor V Leiden mutation, respectively. In two patients, ages 47 and 54, exogenous testosterone appeared to interact with the prothrombin and factor V Leiden mutations, promoting onset of osteonecrosis. Testosterone was stopped. In all three cases, long-term anticoagulation (4, 13, and 10 years) completely relieved pain, there was no joint collapse, and the Ficat stages were unchanged or improved. In patients with primary osteonecrosis (Ficat stages I–II) and major gene thrombophilias, long-term anticoagulation for 4, 13, and 10 years as in our three patients can ameliorate pain, restore normal joint function, prevent joint collapse, and lead to stable or improved X-rays and MRIs, providing a medical approach to treatment of primary osteonecrosis. |
| Databáze: | OpenAIRE |
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