Legg-Calve-Perthes Patogenezinde Endotel İnflamasyonunun Rolü

Abstract

The exact cause of spontaneously healing idiopathic osteonecrosis in the Legg-Calve-Perthes disease is still uncertain. Although it is postulated that thrombotic processes that occur as a result of genetic, epigenetic and environmental factors are at the forefront, the root cause cannot be fully elucidated. According to some views, underlying endothelial pathologies may trigger these events. In this thesis, we aimed to compare the levels of ICAM-1 and E-Selectin, which are markers of endothelial dysfunction and endotheliitis, in the local blood vessels around the femoral neck and peripheral veins of Legg-Calve-Perthes patients and controls of similar age children, and to comprehensively review the findings with histopathological evaluations. There were no statistically significant differences between each group’s ICAM-1 and E-Selectin levels in the femoral neck region or the peripheral vessels. Histopathological examination revealed arterioles with thickened walls and luminal obliteration. Chronic synovitis with plasma cell and lymphocyte infiltration of different severity was detected in more than half of the patients. Findings suggestive of proliferative synovitis with papillary proliferations were seen in two patients and lymphoid follicles were seen in one patient. In the samples with these histological findings, endothelial markers were also mostly above the group mean. These findings do not suggest that endotheliitis alone causes the Legg-Calve-Perthes disease. We have results indicating that arteriolar obliteration and chronic synovitis may be involved simultaneously or at different stages in the etiopathogenesis.