ECE2016 Eposter Presentations Clinical case reports - Pituitary/Adrenal (81 abstracts)
Pituitary and legg calvé perthes syndrome – is there a connexion?
Mirela Puiu 1 , Alina Belceanu 1 , Iulia Crumpei 1 , Anamaria Bursuc 1 , Ioana Armasu 1 , George-Sebastian Zmau 1 , Mihaela Anton 2 , Simona Gavrilescu 3 & Carmen Vulpoi 1
1Department of Endocrinology, Iasi, Romania; 2Department of Endocrinology, Bacau, Romania; 3Children’s Emergency Hospital ‘St. Maria’, Iasi, Romania.
Introduction: Legg calvé perthes (LCP) is a disease characterized by idiopathic avascular necrosis of the proximal femoral epiphysis caused by decreased blood flow. More frequently in boys between 2 and 12 years of age. LCPD is of unknown etiology.
We present two male patients of LCP associated with pituitary disorders.
Case presentation: Case 1: g.i.c., 8 years 8 month, was first addressed to the endocrinology department for investigations of growth retardation. Clinical examination revealed: short stature (−3.2 ds), facial dysmorphism, uneven legs (right< left with 2 cm), right hip pain, no sign of pubertal onset. Radiological examination revealed osteonecrosis of the right femoral head and delayed bone age of ~ 7 years. Somatotropic axis investigations revealed low igf-1 (48 ng/dl, n=64–345). Case 2: n.g.a., 20 years 11 months, with significant orthopedic medical history (6 years: left proximal femoral epiphysiolysis, 19 years: LCP disease of the left hip), was addressed to the endocrinology department for bilateral galactorrhoea, obesity, intermittent headache. The clinical examination revealed: obesity (bmi=36 kg/mp), shorter left leg compared to right leg, right coxa valga, bilateral genu valgum, pubertal stage iv–v (loss of pubic and facial hair, thin voice, erectile dysfunction, reduced testicular volume). Biology confirmed hyperprolactinemia (prl>150 ng/ml, n=2.5–17) with hypogonadotropic hypogonadism (fsh=0.492 mUI/ml, n=0.7–11.1, l h=0.764 mUI/ml, n=0.8–7.6, testosteron=1.3 ng/ml, n=2.8–8); the other pituitary functions were normal. Mri described a pituitary macroadenoma (23/23/22 mm). Cabergoline treatment was started with good results (prl<0.5 ng/ml).
Discussion: LCP is associated with short stature and decreased growth velocity, some literature data considering igf1 deficiency as a causal factor of the osteonecrosis. This affirmation is controversial since GH treatment may induce femoral necrosis. Whatever the causal association, the presence of LCP impose caution in the short stature treatment. We did not find connexions between LCP and prolactinoma, however the concomitance of the two lesions may suggest a yet unknown correlation.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more