{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T19:31:23Z","timestamp":1774553483859,"version":"3.50.1"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81873327"],"award-info":[{"award-number":["81873327"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81774339"],"award-info":[{"award-number":["81774339"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010618","name":"Guangzhou University of Chinese Medicine","doi-asserted-by":"publisher","award":["2019 IIT06"],"award-info":[{"award-number":["2019 IIT06"]}],"id":[{"id":"10.13039\/501100010618","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pediatr"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Perthes disease (Legg-Calv\u00e9-Perthes, LCP) is a self-limited and non-systemic disease occurring in the femoral heads of children, which is mainly manifested as an ischemic necrosis of the femoral head epiphysis, leading to subchondral ossification injury of the femoral head.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>Here we report a case of 11-year-old child with long-term use of high-dose glucocorticoids. With MRI examination finding the epiphyseal necrosis of right humeral head, femur and tibia, and X-ray examination finding bilateral femoral head necrosis, the child was diagnosed as Perthes disease based on his clinical and imaging data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Long-term and high-dose glucocorticoids may be one of the causes of Perthes disease.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12887-021-02755-4","type":"journal-article","created":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T05:03:09Z","timestamp":1628744589000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Can large doses of glucocorticoids lead to Perthes? a case report and review of the literature"],"prefix":"10.1186","volume":"21","author":[{"given":"Guoming","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tengyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaoping","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruilan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haibin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"2755_CR1","doi-asserted-by":"crossref","unstructured":"Divi SN, Bielski RJ. \u201cLegg-Calve-Perthes Disease,\u201cPediatr Ann, 45, 4, e144-149.","DOI":"10.3928\/00904481-20160310-03"},{"key":"2755_CR2","doi-asserted-by":"crossref","unstructured":"Alpaslan AM, Aksoy MC, Yazici M. \u201cInterruption of the blood supply of femoral head: an experimental study on the pathogenesis of Legg-Calve-Perthes Disease\"Arch Orthop Trauma Surg, 127, 6,\u00a0 485\u2013491.","DOI":"10.1007\/s00402-007-0367-y"},{"key":"2755_CR3","doi-asserted-by":"crossref","unstructured":"Eldridge J, Dilley A, Austin H, et al. \u201cThe role of protein C, protein S, and resistance to activated protein C in Legg-Perthes disease,\u201cPediatrics, 107, 6,\u00a0 1329\u20131334.","DOI":"10.1542\/peds.107.6.1329"},{"key":"2755_CR4","doi-asserted-by":"crossref","unstructured":"Glueck C, Crawford A, Roy D, Freiberg R, Glueck H, Stroop D. \u201cAssociation of antithrombotic factor deficiencies and hypofibrinolysis with Legg-Perthes disease\"J Bone Joint Surg Am, 78, 1,\u00a0 3\u201313.","DOI":"10.2106\/00004623-199601000-00002"},{"key":"2755_CR5","doi-asserted-by":"crossref","unstructured":"Szepesi K, P\u00f3s\u00e1n E, H\u00e1rsfalvi J, et al. \u201cThe most severe forms of Perthes\u2019 disease associated with the homozygous Factor V Leiden mutation\"J Bone Joint Surg Br, 86, 3,\u00a0 426\u2013429.","DOI":"10.1302\/0301-620X.86B3.13442"},{"key":"2755_CR6","doi-asserted-by":"crossref","unstructured":"Balasa V, Gruppo R, Glueck C, et al. \u201cLegg-Calve-Perthes disease and thrombophilia\"J Bone Joint Surg Am, 86-A, 12, 2642\u20132647.","DOI":"10.2106\/00004623-200412000-00009"},{"key":"2755_CR7","unstructured":"Moens P, Defoort K, Vancampenhout A, Peerlinck K, Fabry G. 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Ortega Aramburu. \u201c[Thrombophilia and Perthes\u2019 disease?],\u201cAn Esp Pediatr, 53, 1, 12\u201316.","DOI":"10.1016\/S1695-4033(00)77406-6"},{"key":"2755_CR13","doi-asserted-by":"crossref","unstructured":"Hayek S, Kenet G, Lubetsky A, Rosenberg N, Gitel S, Wientroub S. \u201cDoes thrombophilia play an aetiological role in Legg-Calv\u00e9-Perthes disease?,\u201cJ Bone Joint Surg Br, 81, 4, 686\u2013690.","DOI":"10.1302\/0301-620X.81B4.0810686"},{"key":"2755_CR14","doi-asserted-by":"crossref","unstructured":"Gallistl S, Reitinger T, Linhart W, Muntean W. \u201cThe role of inherited thrombotic disorders in the etiology of Legg-Calv\u00e9-Perthes disease,\u201cJ Pediatr Orthop, 19, 1, 82\u201383.","DOI":"10.1097\/01241398-199901000-00018"},{"key":"2755_CR15","doi-asserted-by":"crossref","unstructured":"Koo K, Song H, Ha Y, et al. \u201cRole of thrombotic and fibrinolytic disorders in the etiology of Perthes\u2019 disease\"Clin Orthop Relat Res, 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Martinez Grande. \u201cLegg-Calv\u00e9-Perthes disease and passive smoking,\u201cJ Pediatr Orthop, 20, 3, 326\u2013330.","DOI":"10.1097\/01241398-200005000-00011"},{"key":"2755_CR31","doi-asserted-by":"crossref","unstructured":"Glueck C, Freiberg R, Crawford A, et al. \u201cSecondhand smoke, hypofibrinolysis, and Legg-Perthes disease,\u201cClin Orthop Relat Res, 159\u2013167.","DOI":"10.1097\/00003086-199807000-00019"},{"key":"2755_CR32","doi-asserted-by":"crossref","unstructured":"Su P, Li R, Liu S, et al. \u201cAge at onset-dependent presentations of premature hip osteoarthritis, avascular necrosis of the femoral head, or Legg-Calv\u00e9-Perthes disease in a single family, consequent upon a p.Gly1170Ser mutation of COL2A1,\u201cArthritis Rheum, 58, 6, 1701\u20131706.","DOI":"10.1002\/art.23491"},{"key":"2755_CR33","doi-asserted-by":"crossref","unstructured":"Miyamoto Y, Matsuda T, Kitoh H, et al. \u201cA recurrent mutation in type II collagen gene causes Legg-Calve-Perthes disease in a Japanese family,\u201cHum Genet, vol. 121, no. 5, pp.\u00a0625\u2013629.","DOI":"10.1007\/s00439-007-0354-y"},{"key":"2755_CR34","doi-asserted-by":"crossref","unstructured":"Hall A, Margetts B, Barker D, et al. \u201cLow blood manganese levels in Liverpool children with Perthes\u2019 disease,\u201cPaediatr Perinat Epidemiol, vol. 3, no. 2, pp.\u00a0131\u2013135.","DOI":"10.1111\/j.1365-3016.1989.tb00505.x"},{"key":"2755_CR35","doi-asserted-by":"crossref","unstructured":"Neidel J, Sch\u00f6nau E, Zander D, R\u00fctt J, Hackenbroch M. \u201cNormal plasma levels of IGF binding protein in Perthes\u2019 disease. Follow-up of previous report,\u201cActa Orthop Scand, vol. 64, no. 5, pp.\u00a0540\u2013542.","DOI":"10.3109\/17453679308993688"},{"key":"2755_CR36","doi-asserted-by":"crossref","unstructured":"Neidel J, Zander D, Hackenbroch M. \u201cLow plasma levels of insulin-like growth factor I in Perthes\u2019 disease. A controlled study of 59 consecutive children\"Acta Orthop Scand, 63, 4, 393\u2013398.","DOI":"10.3109\/17453679209154752"},{"key":"2755_CR37","doi-asserted-by":"crossref","unstructured":"Turkmen I, Poyanli O, Unay K, Kemah B, Akan K, Ulusan S. \u201cAssociation between attention deficit and hyperactivity disorder and Perthes disease,\u201cActa Orthop Traumatol Turc, 48, 1, 67\u201372.","DOI":"10.3944\/AOTT.2014.3248"},{"key":"2755_CR38","unstructured":"Berman J, Aran A, Berenstein-Weyel T, Lebel E. \u201cExploring the Association between Legg-Calv\u00e9-Perthes Disease and Attention Deficit Hyperactivity Disorder in Children\"Isr Med Assoc J, 18, 11, 652\u2013654."},{"key":"2755_CR39","doi-asserted-by":"crossref","unstructured":"Sezgin H, Gulman B, Cirakli A, et al. \u201cEffects of circulating endothelial progenitor cells, serum vascular endothelial growth factor and hypogammaglobulinemia in Perthes disease,\u201cActa Orthop Traumatol Turc, 48, 6, 628\u2013634.","DOI":"10.3944\/AOTT.2014.13.0084"},{"key":"2755_CR40","doi-asserted-by":"crossref","unstructured":"Zhao Y, Liao S, Lu R, Dang H, Zhao J, Ding X. \u201cEndothelial nitric oxide synthase gene polymorphism is associated with Legg-Calve-Perthes disease\"Exp Ther Med, vol. 11, no. 5, pp.\u00a01913\u20131917.","DOI":"10.3892\/etm.2016.3111"},{"key":"2755_CR41","doi-asserted-by":"crossref","unstructured":"Hall D, Harrison M, Burwell R. \u201cCongenital abnormalities and Perthes\u2019 disease. Clinical evidence that children with Perthes\u2019 disease may have a major congenital defect\"J Bone Joint Surg Br, vol. 61, no. 1, pp.\u00a018\u201325.","DOI":"10.1302\/0301-620X.61B1.33996"},{"key":"2755_CR42","unstructured":"Garc\u00eda Mata S, Hidalgo Ovejero A, Martinez M, Grande, Fibrinolytic system disorders and Legg-Calve-Perthes disease, 1999."},{"key":"2755_CR43","doi-asserted-by":"crossref","unstructured":"Mukamel M, Litmanovitch M, Yosipovich Z, Grunebaum M, Varsano I. \u201cLegg-Calve-Perthes disease following transient synovitis. 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