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

Abstract

Legg-Calve-Perthes (LCP) disease is characterized by idiopathic avascular osteonecrosis of the epiphysis of the femur head. The main factor that plays a role in the etiology of the disease is decreased blood flow to the epiphysis. Many predisposing factors have been suggested in the etiology of LCP disease, and most have varying degrees of effects. Here we present the case of a boy aged 4 years and 10 months with complaints of short stature and a diagnosis of multiple hypophyseal hormone deficiency, in whom LCP disease and difficult birth-related pituitary stalk interruption syndrome were identified by anamnesis. The present case revealed that LCP disease and hypophyseal hormone deficiency could be secondary to difficult birth and that LCP disease could be secondary to insulin-like growth factor 1 deficiency. Additionally, to the best of our knowledge there is no published case on the relation between LCP disease and insulin-like growth factor 1 deficiency. Therefore, we believe that this case is worthy of presentation.

Keywords: Hypopituitarism; Insulin-like growth factor-1; Legg-Calve-Perthes disease.

Fig. 1. The head of the left femur (arrow) was smaller than normal with a visible subchondral minimal lucent band.

Fig. 2. A small anterior hypophyseal gland and an ectopic posterior hypophyseal gland (circle) are seen in the sagittal T1 midline magnetic resonance image without contrast.