Atraumatic osteonecrosis after estrogen replacement therapy associated with low protein S level in a patient with Turner syndrome.
Atraumatic osteonecrosis has been associated with a variety of clinical conditions including corticosteroid usage, alcoholism, infections, hyperbaric events, storage disorders, marrow-infiltrating diseases, coagulation defects, and some autoimmune diseases. Osteonecrosis due to thrombophilia is an extremely rare condition with only few cases reported previously in the literature. Hormone-replacement therapies cause increased risk of venous thrombosis, probably by causing a synergistic effect with inherited clotting defects. In this article, we report a young female with Turner syndrome, who developed avascular necrosis of the femoral head during treatment with oral estrogen, which was associated with low protein S levels.
Ureten
Kemal
K
Department of Rheumatology (KU), Ministry of Health Diskapi Yildirim Beyazit Research and Educational Hospital, Ankara, Turkey. kemalureten@yahoo.com
Ozturk
M Akif
MA
Bostanci
Ahmet
A
Ceneli
Ozcan
O
Ozbek
Mustafa
M
Haznedaroglu
Ibrahim C
IC
D000328:Adult; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D010020:Osteonecrosis / Q000097:blood*; D018455:Protein S Deficiency / Q000097:blood / Q000139:chemically induced / Q000150:complications*; D012307:Risk Factors; D014424:Turner Syndrome / Q000097:blood / Q000150:complications* / Q000188:drug therapy
D004966:Estrogens, Conjugated (USP)