Hypopituitarism and Legg-Calve-Perthes disease related to difficult delivery

Area of Science:

• Pediatrics
• Endocrinology
• Orthopedics

Background:

• Legg-Calve-Perthes (LCP) disease involves avascular osteonecrosis of the femoral head epiphysis, often linked to reduced blood flow.
• Predisposing factors for LCP disease are varied, but the exact etiology remains complex.
• Multiple hypophyseal hormone deficiency can lead to short stature and other endocrine issues.

Purpose of the Study:

• To present a unique case of Legg-Calve-Perthes disease in a child with multiple hypophyseal hormone deficiency.
• To explore potential secondary causes of LCP disease, including difficult birth and growth factor deficiencies.
• To highlight a possible association between LCP disease and insulin-like growth factor 1 deficiency.

Main Methods:

• Case report of a 4-year-old boy with short stature and diagnosed hypophyseal hormone deficiency.
• Anamnesis revealed a history of difficult birth and pituitary stalk interruption syndrome.
• Clinical evaluation and diagnostic workup for LCP disease and endocrine deficiencies.

Main Results:

• The patient presented with short stature and multiple hypophyseal hormone deficiency.
• Legg-Calve-Perthes disease was diagnosed concurrently.
• Difficult birth was identified as a potential contributing factor to both conditions.
• A potential secondary link between LCP disease and insulin-like growth factor 1 deficiency was observed.

Conclusions:

• Legg-Calve-Perthes disease and hypophyseal hormone deficiency may be secondary to difficult birth.
• This case suggests Legg-Calve-Perthes disease could be a consequence of insulin-like growth factor 1 deficiency.
• The presented case highlights a potentially novel association between LCP disease and insulin-like growth factor 1 deficiency.