<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022023000300155</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Necrosis avascular de la cabeza del fémur en un paciente pediátrico con drepanocitosis: a propósito de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Avascular necrosis of the femoral head in a sickle cell disease pediatric patient: case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Porras-Moreno]]></surname>
<given-names><![CDATA[Adriana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Soto-Herrera]]></surname>
<given-names><![CDATA[Gabriela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Caja Costarricense del Seguro Social Hospital Nacional de Niños &#8220;Doctor Carlos Sáenz Herrera&#8221; Servicio de hematología.]]></institution>
<addr-line><![CDATA[ San José]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Caja Costarricense del Seguro Social Hospital Nacional de Niños &#8220;Doctor Carlos Sáenz Herrera&#8221; Servicio de hematología]]></institution>
<addr-line><![CDATA[ San José]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2023</year>
</pub-date>
<volume>65</volume>
<numero>3</numero>
<fpage>155</fpage>
<lpage>159</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022023000300155&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022023000300155&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022023000300155&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La drepanocitosis o anemia de células falciformes es una hemoglobinopatía hereditaria que se transmite de forma autosómica recesiva, la cual está asociada con episodios de dolor agudo y daño progresivo a órganos blanco que producen un gran impacto en la esperanza y la calidad de vida de quienes la padecen. La necrosis avascular de la cabeza del fémur es una complicación bien conocida en los pacientes con drepanocitosis presente hasta en un 25 % de los pacientes adultos y tanto en un 12 % de los pacientes pediátricos. A continuación, se presenta el caso de un paciente masculino de 9 años con drepanocitosis, quien en cita de control refirió 15 días de coxalgia y claudicación de la marcha. Tras realizar estudios radiológicos se documentó una necrosis avascular de la cabeza del fémur, convirtiéndose de esta manera en el primer caso documentado en el Hospital Nacional de Niños de Costa Rica de un paciente pediátrico con una necrosis avascular de la cadera del fémur como complicación de su drepanocitosis.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ Sickle cell disease is an autosomic recessive hereditary hemoglobin disorder, associated with episodes of acute pain and progressive organ damage with great impact on a patient&#8217;s life expectancy and quality of life. Avascular necrosis of the femoral head is a well-known complication of sickle cell disease affecting almost 25% of adult patients and just in 12% of pediatric patients. Below is the case of a 9-year-old male patient with sickle cell disease, who on a control appointment reported 15 days of hip pain and gait claudication. After performing radiological studies, avascular necrosis of the femoral head was diagnosed, becoming the first case documented at the National Children Hospital of Costa Rica of avascular necrosis of the femoral head as a complication in a pediatric patient with sickle cell disease.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Drepanocitosis]]></kwd>
<kwd lng="es"><![CDATA[necrosis avascular de la cabeza del fémur.]]></kwd>
<kwd lng="en"><![CDATA[Sickle cell disease]]></kwd>
<kwd lng="en"><![CDATA[avascular necrosis of the femoral head.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Amid]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Odame]]></surname>
<given-names><![CDATA[I.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Improving outcomes in children with sickle cell disease: treatment considerations and strategies.]]></article-title>
<source><![CDATA[Paediatric drugs.]]></source>
<year>2014</year>
<volume>16</volume>
<page-range>255-66</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Strouse]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sickle cell disease.]]></article-title>
<source><![CDATA[Handb Clin Neurol]]></source>
<year>2016</year>
<volume>138</volume>
<page-range>311-24</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Adesina]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Brunson]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Keegan]]></surname>
<given-names><![CDATA[THM]]></given-names>
</name>
<name>
<surname><![CDATA[Wun]]></surname>
<given-names><![CDATA[T.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Osteonecrosis of the femoral head in sickle cell disease: prevalence, comorbidities, and surgical outcomes in California.]]></article-title>
<source><![CDATA[Blood Adv.]]></source>
<year>2017</year>
<volume>1</volume>
<page-range>1287-95</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sanders]]></surname>
<given-names><![CDATA[WJ.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A rare case of avascular necrosis in sickle cell trait: a case report.]]></article-title>
<source><![CDATA[BMC hematol]]></source>
<year>2018</year>
<volume>18</volume>
<page-range>5</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lakkakula]]></surname>
<given-names><![CDATA[B.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association between MTHFR 677C&gt;T polymorphism and vascular complications in sickle cell disease: A metaanalysis.]]></article-title>
<source><![CDATA[Trans Clin Biol]]></source>
<year>2019</year>
<volume>26</volume>
<page-range>284-8</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Adekile]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
<name>
<surname><![CDATA[Gupta]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Al-Khayat]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mohammed]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Atyani]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Thomas]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk of avascular necrosis of the femoral head in children with sickle cell disease on hydroxyurea: MRI evaluation.]]></article-title>
<source><![CDATA[Pediatr Blood Cancer.]]></source>
<year>2019</year>
<volume>66</volume>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guerado]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Caso]]></surname>
<given-names><![CDATA[E.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The physiopathology of avascular necrosis of the femoral head: an update.]]></article-title>
<source><![CDATA[Injury]]></source>
<year>2016</year>
<volume>47</volume>
<page-range>S16-s26</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Akinyoola]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
<name>
<surname><![CDATA[Adediran]]></surname>
<given-names><![CDATA[IA]]></given-names>
</name>
<name>
<surname><![CDATA[Asaleye]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Bolarinwa]]></surname>
<given-names><![CDATA[AR.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors for osteonecrosis of the femoral head in patients with sickle cell disease.]]></article-title>
<source><![CDATA[Int orthop]]></source>
<year>2009</year>
<volume>33</volume>
<page-range>923-6</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Worrall]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Smith-Whitley]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Wells]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hemoglobin to hematocrit ratio: the strongest predictor of femoral head osteonecrosis in children with sickle cell disease.]]></article-title>
<source><![CDATA[J Pediatr Orthop.]]></source>
<year>2016</year>
<volume>36</volume>
<page-range>139-44</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Matos]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Alves]]></surname>
<given-names><![CDATA[GB]]></given-names>
</name>
<name>
<surname><![CDATA[de Alcantara]]></surname>
<given-names><![CDATA[WSJ]]></given-names>
</name>
<name>
<surname><![CDATA[Veiga]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Necrosis of the femoral head and health-related quality of life of children and adolescents.]]></article-title>
<source><![CDATA[Acta Ortop Bras.]]></source>
<year>2018</year>
<volume>26</volume>
<page-range>227-230.</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mukisi-Mukaza]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Gomez-Brouchet]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Donkerwolcke]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hinsenkamp]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Burny]]></surname>
<given-names><![CDATA[F.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Histopathology of aseptic necrosis of the femoral head in sickle cell disease.]]></article-title>
<source><![CDATA[Int Orthop.]]></source>
<year>2011</year>
<volume>35</volume>
<page-range>1145-450</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Itzep]]></surname>
<given-names><![CDATA[NP]]></given-names>
</name>
<name>
<surname><![CDATA[Jadhav]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Kanne]]></surname>
<given-names><![CDATA[CK]]></given-names>
</name>
<name>
<surname><![CDATA[Sheehan]]></surname>
<given-names><![CDATA[VA.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous healing of avascular necrosis of the femoral head in sickle cell disease]]></article-title>
<source><![CDATA[Am J Hematol.]]></source>
<year>2019</year>
<volume>94</volume>
<page-range>E160-e2</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
