Growth Hormone Treatment in Children with Perthes Disease and Growth Hormone Deficiency: A Case Report and Literature Review.

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.