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Resolution of apparent growth hormone-dependent growth failure during puberty: a case report
A J Weissberger1, K Y Ho, L Lazarus
1Garvan Institute of Medical Research, St Vincent's Hospital, Sydney, Australia.
Insights
Puberty can restore growth hormone (GH) secretion in children with temporary GH insufficiency. This case shows normal spontaneous and stimulated GH levels after puberty begins.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Biology
Background:
- Growth hormone (GH) deficiency is a potential cause of short stature in children.
- Transient GH insufficiency has been observed in some prepubertal children.
Observation:
- A prepubertal boy presented with apparent GH-dependent growth failure.
- He showed normal GH responses to provocative testing.
- Spontaneous 24-hour GH secretion increased significantly after the onset of puberty.
Findings:
- The patient experienced a marked increase in growth velocity.
- Normal GH secretion was restored following the onset of puberty.
- This represents the first evidence of puberty normalizing both spontaneous and stimulated GH secretion in such cases.
Implications:
- This case supports the concept of transient GH insufficiency.
- It highlights the potential for pubertal recovery of GH secretion.
- Understanding these dynamics is crucial for diagnosing and managing short stature.
Abstract:
A prepubertal boy with apparent growth hormone (GH)-dependent growth failure displayed a marked increase in growth velocity, normal GH responses to arginine/insulin infusion and a fourfold increase in spontaneous 24-hour GH secretion following the onset of normal puberty. The case supports earlier observations of a transient form of GH insufficiency in some short prepubertal children, but represents the first evidence that puberty restores spontaneous as well as stimulated GH secretion in such patients.