Document Detail

Histopathology of aseptic necrosis of the femoral head in sickle cell disease.
MedLine Citation:
PMID:  20830473     Owner:  NLM     Status:  MEDLINE    
This study compares the histopathology of bone biopsies from patients suffering from sickle cell anaemia (homozygote SS) to heterozygote patients (SA) and homozygotes with aseptic osteonecrosis (AA). The sensitivity to bacterial infection of sickle cell patients raises the question of the aetiology of sepsis in the onset of the necrosis. To our knowledge this study is the first to analyse the histopathology of osteonecrosis of the femoral head, at its early stages, in sickle cell anaemia. At the University Hospital of Pointe-à-Pitre, from 1994 to 2007, 38 bone biopsies were obtained from adult patients with avascular necrosis of the femoral head at the time of a core decompression procedure (SS, SC: 27; AS: 5; AA: 6). The histology of the biopsies confirmed the necrosis; all bacteriological cultures were negative. Patients displaying one S gene (SS, SC, AS) compared to homozygote subjects (AA) showed a significant increase of a nonspecific inflammatory granulomatosis (p = 0.003). No relationship was observed between the radiological stages and the histology whatever the genotype (p = 0.1). Inflammatory histopathology without sepsis or advanced alteration characterises the early stages of sickle cell necrosis. This inflammatory process is absent in idiopathic avascular necrosis.
Martin Mukisi-Mukaza; Anne Gomez-Brouchet; Monique Donkerwolcke; Maurice Hinsenkamp; Franz Burny
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Publication Detail:
Type:  Journal Article     Date:  2010-09-10
Journal Detail:
Title:  International orthopaedics     Volume:  35     ISSN:  1432-5195     ISO Abbreviation:  Int Orthop     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-08-03     Completed Date:  2011-12-06     Revised Date:  2012-09-25    
Medline Journal Info:
Nlm Unique ID:  7705431     Medline TA:  Int Orthop     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1145-50     Citation Subset:  IM    
Service d'Orthopédie Traumatologie, CHU de Pointe-à-Pitre, Guadeloupe, France.
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MeSH Terms
Anemia, Sickle Cell / complications,  genetics,  pathology*
Femur Head / pathology*,  radiography
Femur Head Necrosis / etiology,  genetics,  pathology*
Middle Aged
Wegener Granulomatosis / complications,  genetics,  pathology
Young Adult

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