BackgroundGlucose 6-phosphate-isomerase deficiency (GPI) is an uncommon autosomal recessive genetic disorder characterized by chronic asphoric hemolytic anemia, jaundice, and hepatospleenomegaly of varying degrees. Avascular necrosis of the femoral head in children may be caused by Legg-calve-perthes disease or hematological diseases. However, to date, there is no literature reporting on femoral head avascular necrosis as a complication of GPI.Case presentationHerein we report a 6-year-old child admitted with no pain and abnormal gait in both lower extremities for 3 years, the patient received a genetic inspection and radiology test. Full-exon detection and Sanger sequencing verification were performed on the children and their parents C. 553T>A homozygous missense mutation (NM_ 001289790, F 185 I) was found in exon 6 of the GPI gene, which was inherited from parents. The radiology test showed avascular necrosis of the bilateral femoral head. The patient received traction and wore a spica splint every night and non-weight bearing hip joint rehabilitation every day for 12 months, after which, the gait of the femoral head of this patient improved significantly, and follow up radiation results showed the area of avascular necrosis of the femoral head had decreased.ConclusionCareful investigation of GPI children with abnormal gait is recommended to avoid misdiagnosis, GPI combined with avascular necrosis of the femoral head should be considered as a differential diagnosis in GPI children with abnormal gait.
Background:As the capital city of Hunan Province next to Hubei Province very closely, Changsha started Level 1 response of major public health emergency on January 23. After 75 days of lockdown due to Covid-19 epidemic, students in the 9th grade of junior high school started hard training for physical entrance examination. Case Presentation:We report three cases of occult fracture on the same site in adolescents of the same grade since resumption of school after lockdown in covid-19 epidemic. Three students in the 9th grade of junior high school who were facing the physical examination in two weeks are diagnosed the occult fracture of the distal femur. Conclusion:It is recommended that the students, parents, education providers and policy makers should all pay attention to the physical exercise of students that should be from a small amount to a medium amount and then to examination training. The sudden increase in the amount of exercise may cause hidden fracture of young people.
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