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

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.