Why does post-transplant osteonecrosis develop?
Correspondence and offprint requests to: Email: alpersoy{at}uludag.edu.tr’ + u + ‘@’ + d + ”//–> Sir, We read with interest the article by Ekmekci et al. [1], on the association of thrombophilia and osteonecrosis (ON) of the femoral head in renal transplant recipients. We previously reported a case with diffuse ON and severe osteoporosis which was unusual in its presentation in the early post-transplant period, focusing on pre-transplant hormonal changes [2]. Following our report, Dr Weinstein drew our attention to their research supporting glucocorticoid (GC)-induced ON involved in osteocyte apoptosis, by personal communication. They demonstrated that osteoblasts and osteocytes were the direct targets of GC action in vivo, and that excess levels of steroid hormone directly induced apoptosis of these cell types. Ekmekci et al. [1] reported that factor V Leiden and prothrombin gene mutations might be an important risk factor for the development of ON of the femoral head. They observed
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