ESPE Abstracts (2015) 84 P-3-1035

ESPE2015 Poster Category 3 Growth (51 abstracts)

Two Cases with Decelerated Linear Growth, Normal GH – IGF1 Axis with an Exceptional Response to GH Therapy

Fawzia Alyafei a & Ashraf Soliman b

aHamad Medical Hospital, Doha, Qatar; bAlexandria University, Alexandria, Egypt

Introduction: Idiopathic short stature (ISS) describes short children with normal GH secretion. There is a lot of controversy about the outcome of treating ISS children with GH. Exceptional fast growth in response to GH therapy in these children enable scientist to delineate the different etiologies behind this broad term of ISS

Case report: We are reporting two children aged 5 years and 9 years diagnosed with ISS. They presented with short stature with normal birth measurements and nutritional history. They did not have dysmorphic features, skeletal anomalies, goiter or dyspigmentation. The rest of the examination was unrevealing. They had normal CBC, liver and renal functions, sweat chloride, ESR and thyroid function. (Table 1) MRI showed normal pituitary gland.

Treatment and results: A trial of GH therapy was started (0.035 mg/kg per day S.C. HS) with a follow-up every 6 months. Significant growth response to GH was noted exceeding the genetic background (mid-parental HT S.D.s) (table 1).

Table 1
Case 1 Case 2
Age 5 9
Bone age 4 8.5
GV S.D./year −5 −1.1
IGF1 S.D.s −1 −2
Peak GHST (ng/dl) 10 18.5
HT S.D. pre treatment −1.84 −2.4
Estimated adult HT pre treatment 164 cm 144 cm
Duration of treatment with GH 7 years 3.5 years
HT S.D. post treatment 0.83 −1
Estimated adult HT post treatment 181 cm 156.5 cm
Mid parental HT S.D.s −0.6 −2.37

Conclusion: Two short children presented with short stature, decelerated growth rate, normal GH response to provocation, one with low IGF1 and the other with normal IGF1 level. Both responded well to the GH therapy to surpass their mid-parental height S.D.s. Exceptional fast growth in response to GH therapy in these children should be reported to enable scientist to decide about the different outcome of treatment in these patients.

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