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Atraumatic Osteonecrosis After Estrogen Replacement Therapy Associated with Low Protein S Level in a Patient with Turner Syndrome
(Sage Publications Inc, 2010) Üreten, Kemal; Öztürk, M. Akif; Bostancı, Ahmet; Çeneli, Özcan; Özbek, Mustafa; Haznedaroğlu, İbrahim C.
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.