{
   "source_x": "PMC",
   "title": "Elevations in D-dimer and C-reactive protein are associated with the development of osteonecrosis of the hip in HIV-infected adults",
   "doi": "http://dx.doi.org/10.1097/QAD.0b013e32835c206a",
   "pmcid": "PMC5507350",
   "abstract": "BACKGROUND: A high incidence of non-traumatic osteonecrosis has been reported in HIV-infected patients. We investigated the levels of D-dimer and C-reactive protein (CRP) in a cohort of HIV-infected adults with and without osteonecrosis of the femoral head. METHODS: 43 HIV-infected patients with osteonecrosis of the femoral head and a comparison group of 50 HIV-infected patients with negative MR imaging of the hips and for whom serial plasma samples were available were included. D-dimer and CRP levels were measured prior to and at the time of diagnosis for osteonecrosis patients, at the time of negative MR imaging of the hips for controls, and \u22656 months later for both groups. RESULTS: Biomarker levels were elevated at the time of diagnosis in the osteonecrosis cohort compared with controls. Median D-dimer value was 0.32 \u00b5g/mL in the osteonecrosis group compared to <0.22 \u00b5g/mL in the control group (p=0.016). For CRP the corresponding values were 2.52 mg/L and 1.23 mg/L (p=0.003). Post-diagnosis, D-dimer and CRP levels were also elevated in the osteonecrosis patients compared to controls. Linear regression demonstrated a rise in D-dimer levels from pre-diagnosis to diagnosis in the osteonecrosis patients while CRP levels did not change significantly over time. CONCLUSIONS: Compared to controls, patients who developed osteonecrosis had elevated levels of D-dimer and CRP at diagnosis. D-dimer levels increased while CRP levels did not change significantly from pre-diagnosis to diagnosis. These data suggest that patients with higher levels of inflammation are at an increased risk of osteonecrosis.",
   "authors": [
      "['Morse, Caryn G.', 'Dodd, Lori E.', 'Nghiem, Khanh', 'Costello, Rene', 'Csako, Gyorgy', 'Lane, H. Clifford', 'Lozier, Jay N.', 'Kovacs, Joseph A.']"
   ],
   "id": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5507350"
}