title: [A case of hypogonadotrophic hypogonadism causing lumbar stress fracture].
abstract: A 57-year-old man was referred to our hospital for further evaluation on hypogonadotrophic hypogonadism causing a stress fracture of the 4th lumbar vertebrae. Azoospermia had been pointed out at the age 30, but hormonal evaluation had not been performed. Physical examination revealed an eunuchoidal body proportion, a stretched phallus length of 4 cm and bilateral scrotal testes of 6 ml. Hormonal evaluation demonstrated a testosterone level of 13 ng/dl (normal, 320 to 1,030 ng/dl), a luteinizing hormone of 0.2 mU/ml (normal, 1.8 to 9.2 mU/ml) and a follicular stimulating hormone of 1.0 mU/ml (normal, 1.6 to 10.7 mU/ml). Results of a stress test of gonadotrophin-releasing hormone was a low delay type. Computerized tomography showed no abnormality in the hypothalamic-pituitary region. The patient was treated with the substitution therapy of androgen. The therapy was discontinued 6 months later because of severe nipple pain. We should perform hormonal evaluation and other examinations for male infertility.
authors.affiliation: Department of Urology, Saitama Medical Center, Saitama Medical School.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshinaga
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hayashi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ishii
authors.forename: Rena
authors.initials: R
authors.lastname: Ohno
authors.forename: Toshiya
authors.initials: T
authors.lastname: Terao
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Kamata
authors.forename: Toru
authors.initials: T
authors.lastname: Watanabe
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamada
mesh_terms: D015775:Fractures, Stress / Q000209:etiology*; D006065:Gonadotropins, Pituitary / Q000097:blood*; D006801:Humans; D007006:Hypogonadism / Q000150:complications*; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D009845:Oligospermia / Q000150:complications; D010024:Osteoporosis / Q000150:complications*; D013739:Testosterone / Q000097:blood
chemical_list: D006065:Gonadotropins, Pituitary; D013739:Testosterone