Case ReportsIdiopathic osteonecrosis in an adult with familial protein S deficiency and hyperhomocysteinemiaElishkewich, K.; Kaspi, D.; Shapira, I.; Meites, D.; Berliner, S.Author Information K. Elishkewich, I. Shapira and S. Berliner are with the Department of Internal Medicine ‘D', Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; D. Kaspi is with the Department of Orthopedic Surgery, Sapir Medical Center, Kfar Saba, Israel; and D. Meites is with the Anticoagulant Clinic at the Macabee Health Services, Tel Aviv, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. (Received 12 December 2000; revised 12 June 2001; accepted 14 June 2001) Address correspondence to Shlomo Berliner, M.D., Ph.D., Head, Department of Internal Medicine ‘D', Tel-Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel. Tel: (+972) 3 697 3313; fax: (+972) 3 697 4961; e-mail: [email protected] Blood Coagulation & Fibrinolysis: October 2001 - Volume 12 - Issue 7 - p 547-550 Buy Abstract We describe a 36-year-old man with familial protein S deficiency and homozygosity to the methylene tetrahydrofolate reductase (MTHFR) thermolabile variant who had a stroke followed by an episode of idiopathic osteonecrosis that was successfully managed by surgical core decompression. The patient's symptomatic thrombophilia, as well as that of several of his first-degree relatives who also had thrombotic events, raises the possibility that the thrombophilia was a contributing factor to the development of his osteonecrosis. © 2001 Lippincott Williams & Wilkins, Inc.