Y M is a boy who presented at the age of 5.5 years with slow growth He had a birth weight = 3.1 kg and length = 49.5 cm. Infantile and early neonatal periods are uneventful. He had normal development and appropriate nutritional history. No family history of endocrinopathy and/ or short stature was reported. His measurements were: weight= 16.9 kg, Height = 104 cm (HtSDS = -1.8), growth velocity (GV = 1 cm/y) and BMI= 16 and mid-parental height (MPHt) SDS = -0.6. He had no dysmorphic features, skeletal anomalies, goitre or pigmentation. The rest of the examination was unrevealing.

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Abstract PO-0072 Table 1

Growth data of the patient before and after GH therapy

Investigations showed normal CBC, ESR, and liver and renal and thyroid functions. Sweat chloride test, and tissue trans-glutaminase concentrations were normal. His IGF-I level = 70 (IGF-I SDS = -1) and his bone age = 3 years. The peak GH response to clonidine stimulation test = 10 ng/dl. Brain MRI showed normal pituitary gland.

Because of the decelerated growth and marginally low IGF-I a trial of GH therapy was started (0.035 mg/kg/day s.c. HS). A rapid catch-up of growth occured during the first 3 years of treatment that was maintained at a slower pace during the following 5 years. Testicular enlargement started at 11 years and at 12 years his HtSDS = 0.8 and bone age = 12.5 years. His predicted adult height = 181 cm.

Conclusion Prolonged GH treatment of this boy (normal GH-IGF-I axis) with GH unexpectedly resulted in a HTSDS which surpassed his MPHtSDS by 1.4 SD.