Evolving growth hormone deficiency in children with a subnormal secretion of growth hormone

Three growth-retarded children with a normal growth hormone (GH) response to provocative tests, but subnormal 24-hour integrated concentrations of GH and insulin-like growth factor-binding protein 3 (IGF-BP3) are presented. Retesting 3 to 4 years later demonstrated a subnormal GH response to stimulation. The initial subnormal growth rate and IGF-BP3, despite a normal GH response to stimulation, may be secondary to a subnormal integrated concentration of GH.