Atraumatic Osteonecrosis After Estrogen Replacement Therapy Associated with Low Protein S Level in a Patient with Turner Syndrome

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Ureten K., Ozturk M. A., Bostanci A., Ceneli O., Oezbek M., HAZNEDAROĞLU İ. C.

CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS, vol.16, no.5, pp.599-601, 2010 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 16 Issue: 5
  • Publication Date: 2010
  • Doi Number: 10.1177/1076029609339746
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.599-601
  • Keywords: osteonecrosis, protein S deficiency, estrogen, VENOUS THROMBOSIS, DEFICIENCY, RISK, THROMBOPHILIAS
  • Gazi University Affiliated: Yes


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.