Technical mishaps as easily avoidable causes of treatment failure when using pumps for pulsatile administration of...

A patient (19 years old) with Kallmann's syndrome was treated with gonadotropin-releasing hormone (2.5-16 micrograms) administered subcutaneously every 2 h using a portable infusion pump. During 42 weeks of treatment testosterone levels and testicular size did not increase sufficiently although no reasons for this insufficient response were detectable. Therefore the regime of controlling and changing the catheter system was intensified. By this means partial occlusions of the catheter were detected and could be corrected. Afterwards testosterone levels increased immediately and persistently to normal values.