Title:Growth Hormone Treatment in Children with Perthes Disease and Growth
Hormone Deficiency: A Case Report and Literature Review
Volume: 23
Issue: 13
Author(s): Yuzhen Shi, Yanqin Ying, Xiaoping Luo and Ling Hou*
Affiliation:
- Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology,
No. 1095 Jie Fang Avenue, Hankou, Wuhan, 430030, China
Keywords:
Legg-calvé-perthes disease, short stature, perthes disease, growth hormone deficiency, recombinant human growth hormone, idiopathic femoral head necrosis disease, growth hormone stimulation test.
Abstract:
Background: Perthes disease is an idiopathic femoral head necrosis disease in children.
Although it is believed that the prognosis after surgery within 5 years of age is good, there are very
few reports in the literature regarding concurrent growth hormone deficiency and the outcome of
growth hormone treatment. We retrospectively analyzed and summarized the clinical data of patients
with Perthes disease and GHD in a child treated with rhGH for four years.
Case Presentation: We reported the case of an 11.9-year-old boy diagnosed with “Perthes disease”
at 2.7 years. He underwent surgery at the age of 4.8 years and recovered well. At 6.7 years old, he
was admitted for “slow growth in height for more than four years.” Physical examination demonstrated
severe short stature with a height of 108.8 cm (< 3rd percentile, -2.45 standard deviation
(SD)). The major abnormalities observed in the auxiliary examinations included low insulin-like
growth factor-1 (IGF-1) (-1.73SD) and low GH peak levels (< 5 μg/L) in the growth hormone stimulation
test. A diagnosis of complete GHD was confirmed, and low-dose rhGH treatment was administered.
After four years of rhGH treatment, his height reached 152.3 cm (50th-75th percentile, +
0.29 SD). The annual growth rate was approximately 9.1 cm per year, and the curative effect was
significant. No adverse reactions were observed during the treatment.
Conclusion: The benefits of rhGH in children with Perthes disease and GHD may outweigh its
risks. However, its safety requires long-term follow-up evaluation.
