Multiple Fractures in Patient with Graves' Disease Accompanied by Isolated Hypogonadotropic Hypogonadism.
10.11005/jbm.2016.23.1.40
- Author:
Hyon Seung YI
1
;
Ji Min KIM
;
Sang Hyeon JU
;
Younghak LEE
;
Hyun Jin KIM
;
Koon Soon KIM
Author Information
1. Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea. kunsunkim@cnuh.co.kr
- Publication Type:Case Report
- Keywords:
Graves disease;
Hypogonadism;
Osteoporosis
- MeSH:
Absorptiometry, Photon;
Adult;
Asian Continental Ancestry Group;
Autoantibodies;
Bone Density;
Calcium;
Female;
Femoral Fractures;
Femur Neck;
Gonadotropins;
Graves Disease*;
Humans;
Hyperthyroidism;
Hypogonadism*;
Korea;
Magnetic Resonance Imaging;
Osteoporosis;
Pelvis;
Pituitary Gland;
Radiography;
Shoulder;
Spine;
Vitamin D
- From:Journal of Bone Metabolism
2016;23(1):40-44
- CountryRepublic of Korea
- Language:English
-
Abstract:
Isolated hypogonadotropic hypogonadism (IHH) is known to decrease bone mineral density due to deficiency of sex steroid hormone. Graves' disease is also an important cause of secondary osteoporosis. However, IHH does not preclude the development of primary hyperthyroidism caused by Graves' disease, leading to more severe osteoporosis rapidly. Here, we describe the first case of 35-year-old Asian female patient with IHH accompanied by Graves' disease and osteoporosis-induced multiple fractures. Endocrine laboratory findings revealed preserved anterior pituitary functions except for secretion of gonadotropins and showed primary hyperthyroidism with positive autoantibodies. Sella magnetic resonance imaging showed slightly small sized pituitary gland without mass lesion. Dual energy X-ray absorptiometry revealed severe osteoporosis in lumbar spine and femur neck of the patient. Plain film radiography of the pelvis and shoulder revealed a displaced and nondisplaced fracture, respectively. After surgical fixation with screws for the femoral fracture, the patient was treated with antithyroid medication, calcium, and vitamin D until now and has been recovering fairly well. We report a patient of IHH with Graves' disease and multiple fractures that is a first case in Korea.
