Thyroid function in Legg-Calvé-Perthes disease: cross-sectional and longitudinal study

Area of Science:

• Pediatric Endocrinology
• Orthopedic Research
• Metabolic Studies

Background:

• Legg-Calvé-Perthes disease (LCPD) is a childhood hip disorder of unknown etiology.
• Systemic factors are increasingly suspected in the pathogenesis of LCPD.
• Thyroid hormone levels in LCPD patients have not been extensively studied.

Purpose of the Study:

• To investigate thyroid function in children diagnosed with Legg-Calvé-Perthes disease.
• To compare thyroid hormone levels between LCPD patients and healthy controls.
• To explore potential correlations between thyroid hormone levels and disease severity in LCPD.

Main Methods:

• Cross-sectional study comparing 59 children with LCPD to 239 healthy controls.
• Measurement of plasma concentrations of free thyroxine (FT4) and free triiodothyronine (FT3).
• Longitudinal evaluation of thyroid function in 38 LCPD patients to assess changes over time and with treatment.

Main Results:

• Children with LCPD exhibited significantly higher plasma concentrations of FT4 (16% increase, p < 10(-8)) and FT3 (10% increase, p < 0.001) compared to controls.
• Elevated FT4 levels showed a tendency towards correlation with more extensive femoral head necrosis (p < 0.015).
• These hormonal alterations were evident at diagnosis and remained relatively stable regardless of disease stage or treatment.

Conclusions:

• Children with LCPD demonstrate moderate but significant alterations in thyroid hormone levels.
• These findings support the hypothesis of underlying systemic abnormalities in LCPD.
• The precise relationship between these thyroid function changes and the development of femoral head necrosis in LCPD remains to be elucidated.