Simultaneous bilateral total hip arthroplasty for managing hip arthropathy secondary to Dianzani autoimmune lymphoproliferative disease: A case report

Abstract

We present a rare presentation of bilateral hip arthropathy secondary to Dianzani autoimmune lymphoproliferative disease (DALD) that was managed with simultaneous bilateral cementless total hip arthroplasties (THAs). A 34-year-old female patient presented with a history of generalized joint pain and bilateral hand deformities. Her treating rheumatologist acknowledged that the patient was diagnosed with a rare autoimmune disease, DALD, for which she received immune-modulating drugs and steroids as management. She presented in January 2024 with bilateral hip pain; her functional score as per the Harris Hip Scoring (HHS) system was 34.5 and 34.2 for the right and left hips, respectively. The radiographs revealed bilateral hip arthropathy associated with bilateral osteonecrosis of the femoral head. After consultation with her treating rheumatologist and the anesthesiologist, her hip condition was managed by bilateral cementless THA performed in the same setting. At the last follow-up (11 months postoperatively), her functional scores improved significantly (HHS were 87 and 83.7 for the right and left hips, respectively), and the radiographs showed proper component positioning. This case presents a rare autoimmune disease (DALD) that led to bilateral hip arthropathy, which was treated successfully by bilateral THA. Collaborating with other specialties to ensure accurate patient diagnosis and management is paramount.