title: Hemochromatosis and femoral head aseptic osteonecrosis: a nonfortuitous association?
abstract: 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.
authors.affiliation: Department of Internal Medicine, Pitie-Salpetriere Hospital, Paris, France. florence.rollot@cch.ap-hop-paris.fr
authors.forename: Florence
authors.initials: F
authors.lastname: Rollot
authors.forename: Bertrand
authors.initials: B
authors.lastname: Wechsler
authors.forename: Le Thi Huong
authors.initials: le TH
authors.lastname: du Boutin
authors.forename: Christian
authors.initials: C
authors.lastname: De Gennes
authors.forename: Zahir
authors.initials: Z
authors.lastname: Amoura
authors.forename: Eric
authors.initials: E
authors.lastname: Hachulla
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Piette
mesh_terms: 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
chemical_list: C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins