Background: Growth response in growth hormone deficient children during growth hormone (GH) replacement therapy rarely fulfil our projections and patients expectations. We here report 3 cases with outstanding growth response.
Case reports: First patient was diagnosed as gluten enteropathy in early childhood, but the diet did not improve his growth. At age of 7 years the diagnosis of isolated growth hormone deficiency (GHD) was established and GH substitution therapy introduced. Next 2 years his growth velocity increased to 10 cm/year. Routine head MRI revealed hypothalamic tumour. Severe growth failure in 8-years-old boy with history of purulent meningitis in toddler period and head trauma at age of six. MRI discovered congenital pituitary abnormality (pituitary hypoplasia and ectopic posterior pituitary). Combined substitution therapy improved his height from −3S.D. to +0.67 S.D. An Empty Sella Syndrome was diagnosed in short obese boy with delayed puberty. At diagnosis his height of 148.8 cm was −1.88 S.D. (P3). During 4 years of combined therapy he achieved height of 184 cm (P90), +1.28 S.D.
Conclusion: Mechanisms of excellent growth response in these GH deficient children certainly include growth because of insulin, concomitant hypogonadism, but somatostatin deficiency may also be considered.
Funding: Supported by a grant from the Ministry of Science of Republic of Serbia, No 41018.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology