Osteoporosis of male patient!!
A 37-year-old man presented to the emergency department at our hospital on October 2012 with a 4-month history of worsening lower back pain. There was no history of trauma or falls. He was unemployed and lived with his mother. He took no medications or supplements, did not smoke, consume excessive alcohol, or use illegal drugs, and had never been treated with corticosteroids. He had no history of prior fractures. Family history was negative for gonadal, endocrine, or bone diseases. Review of systems was remarkable for markedly delayed puberty for which he had received testosterone injections starting at 16 years of age. Three years later, testosterone replacement therapy was terminated by the treating physician, after he responded well in terms of growth and development of secondary male sexual characteristics. He remarked decreased libido for several years and absence of morning erections.
@apyayee Hypogonadism is a common cause of osteoporosis in men (rates ranging from 16 to 30% as the attributable cause). It is classified either as hypergonadotropic (primary gonadal failure) or hypogonadotropic (secondary to a defect in the hypothalamic-pituitary axis) hypogonadism with the latter being due to congenital (defects in gonadotropin releasing hormone (GnRH) neurons, GnRH regulating neurons, and LH and FSH secreting cells) or acquired etiologies (structural defects or reversible causes). Congenital hypogonadotropic hypogonadism is subclassified into normosmic, where the sense of smell is intact (40%), or anosmic/hyposmic (absent/decreased sense of smell), the latter also being referred to as Kallmann syndrome (60%).