Slipped Capital Femoral Epiphysis Associated With Hypogonadism: A Case Report And Literature Review

Autor: Sachiko Kitagawa, Kenjiro Wakabayashi, Yoshiteru Azuma, Hirokazu Kurahashi, Kei Takazawa, Kenichi Kashimada, Junko Takagi, Toshiyuki Yamamoto, Okumura Akihisa, Hideyuki Iwayama
Rok vydání: 2022
DOI: 10.21203/rs.3.rs-1199527/v1
Popis: Background: Slipped capital femoral epiphysis (SCFE) is a displacement of the femoral head epiphysis that is sometimes associated with endocrinopathies. We report the case of a 12-year-old girl with hypergonadotropic hypogonadism (HH) who developed SCFE during growth hormone therapy (GHT). We also performed a systematic review of the cases of SCFE and hypogonadism in the literature. Case presentation: The patient was diagnosed with HH based on the absence of ovaries and a uterus. Her medical history included GHT for 9 years as she was small for gestational age. Chromosomal and genetic analyses revealed no pathogenic abnormalities. Radiographs revealed a left SCFE with a 28.7° posterior tilt angle. GHT was discontinued, and bilateral in situ screw fixation was performed. Sex hormone therapy (SHT) was initiated. Two years later, the patient recovered.Methods: We reviewed the cases of hypogonadism complicated with SCFE. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement were followed. Case reports of patients were retrieved using PubMed on November 17, 2021.Results: A total of 44 cases of SCFE and hypogonadism were identified, including this case. Endocrinological complications included growth hormone deficiency (n = 18), being overweight (n = 9), and hypothyroidism (n = 25). Hormone replacement was administered before (SHT, n = 6; GHT, n = 12) and after surgery (SHT, n = 21; GHT, n = 11). SCFE surgery was invasive (minimal, n = 19; moderate, n = 10; high, n = 8). Orthopedic complications were observed in four cases. Conclusions: If hypogonadism occurs during GHT, SCFE should be noted. Hypogonadism should be studied to determine the effects of hormonal replacement on SCFE.
Databáze: OpenAIRE