Avascular Necrosis of Bone Associated With Primary Antiphospholipid Syndrome

In Brief We describe, the case of a 34-year-old mestizo Mexican woman with previous history of fetal loss, deep vein thrombosis that developed avascular necrosis (AVN) of the right knee with strong positive levels of anticardiolipin antibodies (aCL) IgG and IgM. AVN of bone in association with aCL has been seen principally in systemic lupus erythematosus patients. However, few cases have been reported of AVN as a clinical manifestation of primary antiphospholipid syndrome. A review of the association of aCL and AVN in patients with systemic lupus erythematosus, primary antiphospholipid syndrome, and idiopathic osteonecrosis is presented. This patient had no SLE, steroid treatment or other evident causes so is felt to be an additional example of AVN related to anticardiolipin antibodies.