Hemochromatosis and femoral head aseptic osteonecrosis: a nonfortuitous association?
Chondrocalcinosis, chronic pseudo-osteoarthritis arthropathy, and osteoporosis are classic osteoarticular complications of hemochromatosis (HC). Within HC, femoral head aseptic osteonecrosis (FHAO) is not notified in textbooks. We describe 3 cases of FHAO occurring in this setting in 3 patients homozygous for the C282Y mutation on HFE gene who had no other risk factors for FHAO. FHAO was diagnosed 9 years before (Case 1), concomitantly with (Case 3), or 9 years after HC (Case 2). In one case, FHAO occurred although phlebotomies were regularly carried out. There are scarce data available in the literature on HC and FHAO. Our observations suggest FHAO may be an indicator for HC, and iron balance should be determined before considering FHAO as idiopathic. Thus phlebotomy may not be protective against the occurrence of FHAO. Studies are needed to determine the prevalence of HC in consecutive patients with FHAO.
Rollot
Florence
F
Department of Internal Medicine, Pitie-Salpetriere Hospital, Paris, France. florence.rollot@cch.ap-hop-paris.fr
Wechsler
Bertrand
B
du Boutin
Le Thi Huong
le TH
De Gennes
Christian
C
Amoura
Zahir
Z
Hachulla
Eric
E
Piette
Jean-Charles
JC
D000328:Adult; D005260:Female; D005271:Femur Head Necrosis / Q000150:complications* / Q000235:genetics / Q000473:pathology; D020022:Genetic Predisposition to Disease; D006432:Hemochromatosis / Q000150:complications* / Q000235:genetics / Q000473:pathology; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I / Q000235:genetics; D006720:Homozygote; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008565:Membrane Proteins / Q000235:genetics; D008875:Middle Aged; D009154:Mutation
C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins