Hemochromatosis and Femoral Head Aseptic Osteonecrosis: A Nonfortuitous Association?
FLORENCE ROLLOT, BERTRAND WECHSLER, LE THI HUONG du BOUTIN, CHRISTIAN DE GENNES,
ZAHIR AMOURA, ERIC HACHULLA, JEAN-CHARLES PIETTE
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. (J Rheumatol 2005;32:376-8)
Key Indexing Terms:
HEMOCHROMATOSIS
FEMORAL HEAD
HIP ASEPTIC OSTEONECROSIS
From the Department of Internal Medicine, Pitié-Salpêtrière Hospital, Paris; and Department of Internal Medicine, Claude Huriez Hospital, Lille, France.
F. Rollot, MD; B. Wechsler, MD; L.T.H. du Boutin, MD; C. De Gennes, MD; Z. Amoura, MD; J-C. Piette, MD, Pitié-Salpêtrière Hospital, Paris; E. Hachulla, MD, Claude Huriez Hospital, Lille.
Address reprint requests to Dr. F. Rollot, Internal Medicine Department, Cochin Hospital, 27 rue du faubourg Saint-Jacques, 75014 Paris, France. E-mail: florence.rollot@cch.ap-hop-paris.fr
Submitted December 31, 2003; revision accepted September 15, 2004.
