Outcomes of severe aplastic anemia (SAA) have drastically improved over the last decade with most patients being cured after an appropriate therapy. Long-term side effects are hence becoming increasingly important. Avascular necrosis (AVN) is one of such debilitating complications. We hereby report the unusual association of AVN of hip in two pediatric patients who were treated with immunosuppressive therapy (IST) with short course of low-dose steroids and discuss the existing literature.
Shah KN, Racine J, Jones LC, et al. Pathophysiology and risk factors for osteonecrosis. Curr Rev Musculoskelet Med 2015;8(3):201–209. DOI: 10.1007/s12178-015-9277-8.
Fink JC, Leisenring WM, Sullivan KM, et al. Avascular necrosis following bone marrow transplantation: a case-control study. Bone 1998;22(1):67–71. DOI: 10.1016/S8756-3282(97)00219-6.
Murphey MD, Roberts CC, Bencardino JT, et al. ACR appropriateness criteria osteonecrosis of the hip. J Am Coll Radiol 2016;13(2):147–155. DOI: 10.1016/j.jacr.2015.10.033.
Konopacki J, Porcher R, Robin M, et al. Long-term follow up after allogeneic stem cell transplantation in patients with severe aplastic anemia after cyclophosphamide plus antithymocyte globulin conditioning. Haematologica 2012;97(5):710–716. DOI: 10.3324/haematol.2011.050096.
Marsh JC, Zomas A, Hows JM, et al. Avascular necrosis after treatment of aplastic anemia with antilymphocyte globulin and high-dose methylprednisolone. Br J Haematol 1993;84(4):731–735. DOI: 10.1111/j.1365-2141.1993.tb03153.x.
Hartung DH, Olson ST, Bessler M. Acquired aplastic anaemia in children. Pediatric Clin North Am 2013;60(6):1311–1336. DOI: 10.1016/j.pcl.2013.08.011.
Park J, Jun J, Kim Y, et al. Osteonecrosis of the hip in patients with aplastic anemia. J Korean Med Sci 2002;17(6):806–810. DOI: 10.3346/jkms.2002.17.6.806.
Plichta P, Pawelec K. Avascular necrosis of the femoral head in a patient with severe aplastic anaemia. Med Wieku Rozwoi 2011;15(1):101–105.