Slipped Capital Femoral Epiphysis after 2 Months from Starting Growth Hormone Therapy

Wasnaa Hadi Abdullah, Hussain Alsaffar
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Abstract

Abstract Recombinant growth hormone (GH) is a widely used hormonal therapy for children and adolescents with GH deficiency or short stature related to certain conditions. Generally, GH therapy has a good safety profile; however, it could have rare but significant orthopaedic complications including slipped capital femoral epiphysis (SCFE). Pediatric endocrinologists are aware of these possible complications, and they are responsible for appropriately counseling their patients before commencing this hormone. However, the pediatric endocrinologist may not be the first clinician who encounters the orthopaedic complications of GH, as the patient may seek an emergency medical opinion from people from other specialties. Here, we report the case of a 13-year-old Iraqi adolescent boy who presented with limping that appeared only 2 months after receiving GH (0.035 mg/kg/d). He was diagnosed with SCFE in a relatively very short time after commencement of the treatment. Despite this, the patient was not considered to be at high risk of SCFE. A careful evaluation of SCFE in patients complaining of a limp or hip and knee pain during GH therapy is highly recommended.
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开始生长激素治疗2个月后发生股骨头骨骺滑动
摘要重组生长激素(GH)是一种广泛应用于儿童和青少年生长激素缺乏或与某些条件有关的身材矮小的激素治疗。一般来说,生长激素治疗具有良好的安全性;然而,它可能有罕见但显著的骨科并发症,包括股骨头骨骺滑动(SCFE)。儿科内分泌学家意识到这些可能的并发症,他们有责任在开始使用这种激素之前适当地咨询他们的病人。然而,儿科内分泌学家可能不是第一个遇到GH骨科并发症的临床医生,因为患者可能会向其他专业的人寻求紧急医疗意见。在这里,我们报告了一个13岁的伊拉克青春期男孩,他在接受生长激素(0.035 mg/kg/d)仅2个月后出现跛行。他在开始治疗后相对较短的时间内被诊断为SCFE。尽管如此,该患者并未被认为具有SCFE的高风险。强烈建议对生长激素治疗期间抱怨跛行或髋关节和膝关节疼痛的患者进行SCFE仔细评估。
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