Familial cases of Mexican patients with Legg-Calvé-Perthes disease

BackgroundLegg-Calvé-Perthes Disease (LCPD) is described as an avascular necrosis of the femoral head. Although its etiology is still not fully understood, evidences suggest heritable thrombotic disorders and other factors may be implicated in its onset and progress. Our objective is to describe, in three enrolled families, the genetic, biochemical and environmental factors that may be associated with the etiology and development of LCPD. MethodsTherefore, we set out to evaluate the following alterations of collagen genes: MTHFR rs1801133, CBS rs115742905, and PT rs1799963 and their relationship with LCPD. Thrombophilia associated markers (FI, FII, FV, FVII, FVIII, FIX, FX, FXI, FXII, FvW, PC, PS, AT, and homocysteine) were evaluated using coagulometry methods. Results: Seven LCPD patients and 14 healthy volunteers were enrolled. Concentrations in hemoglobin (p ≤ 0.0001), fibrinogen (P ≤ 0.0001), homocysteine (p = 0.0414), factor IX activity percentage (p ≤ 0.0001), and protein S (p = 0.0478) showed statistically significant differences. None of the evaluated polymorphisms showed statistically significant differences. However, all patients presented the mutated MTHFR C677T polymorphism in a homozygous (T/T) or heterozygous manner (C/T).ConclusionsOur results show environmental elements from every family and hemostatic disorders may be involved in suffering and developing LCPD. Also, heritable factors could contribute to the onset of the disease. Clearly, environmental, genetic, and prothrombotic factors are involved in this pathology.