Perthes' disease and blood manganese levels

Perry, Christopher; Taylor, John F.; Nunn, AJ; Dangerfield, Peter; Delves, H. T.

doi:10.1136/adc.82.5.428f

Cited by 9 publications

(6 citation statements)

References 1 publication

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“…Low blood manganese levels were noted in children with LCPD in Liverpool [ 144 ], but refuted by others [ 145 ]. An increase in IgG and IgM, but not IgA serum immunoglobulin levels in LCPD, are described [ 146 ], suggesting that immunological mechanisms may mediate certain changes in LCPD.…”

Section: Resultsmentioning

confidence: 99%

The Epidemiology and Demographics of Legg-Calvé-Perthes' Disease

Loder

Skopelja

2011

ISRN Orthopedics

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The etiology of Legg-Calvé-Perthes' disease (LCPD) is unknown. There are many insights however from epidemiologic/demographic information. A systematic medical literature review regarding LCPD was performed. The incidence ranges from 0.4/100,000 to 29.0/100,000 children <15 years of age. There is significant variability in incidence within racial groups and is frequently higher in lower socioeconomic classes. The typical age at presentation ranges from 4 to 8 years (average 6.5 years), except for children from the Indian subcontinent (average 9.5 years). There is a mild familial component. The children demonstrate impaired growth in height, skeletal age, and birth weight. This impaired growth coincides with an age appropriate reduced somatomedin A activity and decreased levels of IGF. LCPD can be associated with abnormalities in the coagulation cascade, including an increase in factor V Leiden mutation, low levels of protein C and/or S, and decreased antithrombin activity. There is decreased turnover in type I collagen and synthesis of type III collagen, as well as reduced levels of urinary glycosaminoglycans in the active phases of the disorder. Subtle abnormalities in the opposite hip and other minor/major congenital defects are reported. Children with LCPD are active and score abnormally in certain standardized psychological tests.

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Section: Resultsmentioning

confidence: 99%

The Epidemiology and Demographics of Legg-Calvé-Perthes' Disease

Loder

Skopelja

2011

ISRN Orthopedics

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“…The best investigated nutritional deficiency is manganese deficiency, as it was proven to cause similar growth failure in chicks (Hall et al, ). Whilst an initial study of manganese deficiency was highly suggestive of a nutritional deficiency (Hall et al, ), a subsequent confirmatory study was unable to replicate these results (Perry et al, ), making the nutritional component uncertain. There is no strong association with endocrinopathies, with investigations for hypothyroidism and growth hormone deficiencies failing to yield consistent findings (Kenet et al, ; Vosmaer et al, ; Perry and Hall, ).…”

Section: Skeletal Immaturitymentioning

confidence: 99%

Skeletal immaturity, rostral sparing, and disparate hip morphologies as biomechanical causes for Legg‐Calvé‐Perthes' disease

et al. 2016

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Legg-Calvé-Perthes' (Perthes') disease is a developmental disease of the hip joint that may result in numerous short and long term problems. The etiology of the disease remains largely unknown, but the mechanism is believed to be vascular and/or biomechanical in nature. There are several anatomical characteristics that tend to be prevalent in children with Perthes' disease, namely: skeletal immaturity, reduced height, and rostral sparing. We present an overview of the literature, summarizing the current understanding of the pathogenesis, particularly related to how the formation of the vasculature to the femoral epiphysis places children aged 5-8 at a higher risk for Perthes' disease, how skeletal immaturity and rostral sparing could increase the probability of developing Perthes' disease, and how animal models have aided our understanding of the disease. In doing so, we also explore why Perthes' disease is correlated to latitude, with populations at higher latitudes having higher incidence rates than populations closer to the Equator. Finally, we present five hypotheses detailing how Perthes' disease could have a biomechanical cause. Clin. Anat. 29:759-772, 2016. © 2016 Wiley Periodicals, Inc.

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“…The patients are below average in stature, have retarded skeletal maturation, and skeletal disproportion 23 Hall and colleagues4 noted that similar disproportionate growth is found in chickens suffering from trace metal deficiency, and found low serum manganese concentrations in their patients, but this has not been confirmed 5. Glueck and colleagues6 reported that patients had a deficiency of antithrombin factors, but this is unproven 7.…”

mentioning

confidence: 99%

The incidence and distribution of Legg-Calve-Perthes' disease in Liverpool, 1982-95

Margetts

Perry²,

Taylor³

et al. 2001

Archives of Disease in Childhood

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Aims-To determine the incidence and distribution of Legg-Calvé-Perthes' disease in Liverpool, in the period 1982-95. Methods-Examination of information in a register, analysing the patients' addresses by indices of deprivation. Results-A total of 122 white children were diagnosed as having Perthes' disease during the study, whereas black and minority groups form 5.8% of the population. The incidence rate in inner Liverpool had decreased to 10.5 in the period 1990-95. Simple Spearman correlations revealed an association between the disease incidence in electoral wards and deprivation. Regression analysis showed that for the period 1990-95 the most powerful eVects on incidence were increases in ward deprivation since 1976, the percentage free school meals in 1986, the ward Health Index in 1981, and the percentage low birth weight in 1981. Conclusions-We suggest that environmental influences may come into play some years before a child presents with pain in the hip. There may be a genetic predisposition to the disease. (Arch Dis Child 2001;84:351-354)

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Perthes' disease and blood manganese levels

Cited by 9 publications

References 1 publication

The Epidemiology and Demographics of Legg-Calvé-Perthes' Disease

The Epidemiology and Demographics of Legg-Calvé-Perthes' Disease

Skeletal immaturity, rostral sparing, and disparate hip morphologies as biomechanical causes for Legg‐Calvé‐Perthes' disease

The incidence and distribution of Legg-Calve-Perthes' disease in Liverpool, 1982-95

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