Elevated levels of lipoprotein(a) in familial bone marrow edema syndrome of the hip

There is controversy whether hone marrow edema syndrome represents a distin ct transient disease or reflects an early reversible phase of spontaneous o steonecrosis of the hip. Hypofibrinolysis on the basis of elevated plasma l evels of plasminogen activator inhibitor or lipoprotein(a) or both has been reported to favor the development of bone marrow edema syndrome and nontra umatic avascular necrosis. The current authors report on the familial occur rence of transient bone marrow edema syndrome of the hip in three female fa mily members. Plasma concentrations of lipoprotein(a) were elevated in all three patients, whereas serum levels of plasminogen activator inhibitor wer e within normal ranges. This first familial description of transient bone m arrow edema syndrome of the hip strongly suggests that a genetically determ ined elevation of lipoprotein(a) may be an important predisposing factor in these patients.