Evaluation of Possible Risk Factors for Avascular Necrosis of the Femoral head in patients with Sickle Cell Disease

Abstract 4819

Sickle cell disease is one of the most common causes of avascular necrosis (AVN) of the femoral head. many previous studies have investigated the risk factors for AVN with conflicting conclusions. We hereby report the results of a total of 44 adult patients (26 males and 18 females, age 18–56 years) with severe sickle cell disease seen in our hematology clinic who were investigated for the presence of AVN. Out of these patents 24 (55%) had AVN of the femoral head (6 bilateral and 18 unilateral). All of these patients had further investigations including methelene tetrahydrofolate reductase (MTHFR) gene mutation by molecular technique, along with Hb F level, Hb A2 level and MCV. Six of the 24 AVN patients (24%) were positive for either heterozygous or homozygous for C677T variant compared with four out of the 20 who did not have AVN (the difference is not statistically significant). HbF level was statistically higher in patients with AVN (P- value 0.03). In conclusion, we confirm here that patients with sickle cell disease and AVN have high prevalence of MTHFR mutation and higher level of Hb F, both of which which could be contributing factors for AVN in patients with Sickle Cell Disease.