Hashimoto's hypothyroidism presenting with SUFE (slipped upper femoral epiphysis)

Uday, Suma; Scott, Bradley; Alvi, Sabah

doi:10.1136/bcr-2013-203095

Cited by 3 publications

(1 citation statement)

References 3 publications

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“…However, an effect on the growth plate, if any, has not yet been investigated. Another pathway is the link between high leptin levels and thyroiditis, the most common cause of hypothyroidism (Procaccini et al 2015 ) and the association of hypothyroidism with SCFE (Marquez et al 2014 , Uday et al 2014 , Kadowaki 2017 ). Case series and smaller retrospective studies in patients with SCFE (Loder et al 1995 ) have demonstrated abnormal levels of thyroid hormone typical for hypothyroidism, but this study is the first to show a 3-fold higher risk of hypothyroidism in patients with SCFE compared with their matched controls in a population-based setting.…”

Section: Discussionmentioning

confidence: 99%

Fate of patients with slipped capital femoral epiphysis (SCFE) in later life: risk of obesity, hypothyroidism, and death in 2,564 patients with SCFE compared with 25,638 controls

Hailer

2020

Acta Orthopaedica

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Background and purpose — Associations between obesity and slipped capital femoral epiphysis (SCFE) during adolescence are described; however, few studies report on the lifetime risk of obesity in patients with SCFE. In addition, with the obesity epidemic in children and adolescents, an increasing incidence of SCFE might be expected. An association of SCFE with hypothyroidism seems ambiguous, and the association between SCFE and depression and all-cause mortality has not yet been evaluated. This study investigates the associations of SCFE with obesity, hypothyroidism, depression, and mortality, and putative changes in the yearly incidence of SCFE. Patients and methods — 2,564 patients diagnosed with SCFE at age 5–16 diagnosed between 1964 and 2011 were identified in the Swedish Patient Register. These were matched for age, sex, and residency with unexposed control individuals. Cox regression models were fitted to estimate the risk of obesity, hypothyroidism, depression, and death, in exposed compared with unexposed individuals. Results — The risk of obesity (HR 9, 95% CI 7–11) and hypothyroidism (HR 3, CI 2–4) was higher in SCFE patients compared with controls. There was no increase in the risk of developing depression (HR 1, CI 1–1.3) in SCFE patients. In contrast, all-cause mortality was higher in SCFE patients than in controls (HR 2, CI 1–2). The incidence of SCFE did not increase over the past decades. Interpretation — Patients with SCFE have a higher lifetime risk of obesity and hypothyroidism and a higher risk of all-cause mortality compared with individuals without SCFE. These findings highlight the lifetime comorbidity burden of patients who develop SCFE in childhood, and increased surveillance of patients with a history of SCFE may be warranted. The incidence of SCFE did not increase over the last decades despite increasing obesity rates.

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Section: Discussionmentioning

confidence: 99%

Fate of patients with slipped capital femoral epiphysis (SCFE) in later life: risk of obesity, hypothyroidism, and death in 2,564 patients with SCFE compared with 25,638 controls

Hailer

2020

Acta Orthopaedica

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The Thyroid Gland

Peters

Schoenmakers

2019

Brook's Clinical Pediatric Endocrinology

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Prepubertal onset of slipped capital femoral epiphysis associated with hypothyroidism: a case report and literature review

Kadowaki¹,

Hori²,

Matsumoto³

et al. 2017

BMC Endocr Disord

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BackgroundSlipped capital femoral epiphysis (SCFE) is a common hip disorder characterized by displacement of the capital femoral epiphysis from the metaphysic through the femoral epiphyseal plate. SCFE usually occurs during puberty, with obesity a common risk factor. We experienced a rare case of SCFE associated with hypothyroidism in a prepubescent patient who was not obese.Case presentationThe patient was an 8-year-old boy suffering from bilateral SCFE with hypothyroidism. The patient’s growth had started to slow at 4 years of age, and at 8 years he was of short stature. During his evaluation for SCFE management, primary hypothyroidism was diagnosed due to the presence of anti-thyroid peroxidase and anti-thyroglobulin antibodies. After the patient was treated for hypothyroidism, which improved his thyroid function, surgery was performed for bilateral SCFE.ConclusionsAmong the 42 patients with SCFE associated with hypothyroidism in the literature, most SCFE occurred during puberty or in adults with delayed epiphyseal closure. Only two patients (4.8%), including the present patient, were ≤9 years old. Although being overweight or obese is common for patients with SCFE associated with hypothyroidism (76.0%), it was not observed in the present case. Persistent hypothyroidism, however, may be a risk factor for SCFE even before puberty and without obesity.

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Hashimoto's hypothyroidism presenting with SUFE (slipped upper femoral epiphysis)

Cited by 3 publications

References 3 publications

Fate of patients with slipped capital femoral epiphysis (SCFE) in later life: risk of obesity, hypothyroidism, and death in 2,564 patients with SCFE compared with 25,638 controls

Fate of patients with slipped capital femoral epiphysis (SCFE) in later life: risk of obesity, hypothyroidism, and death in 2,564 patients with SCFE compared with 25,638 controls

The Thyroid Gland

Prepubertal onset of slipped capital femoral epiphysis associated with hypothyroidism: a case report and literature review

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