Endocrine Abstracts

Treatment for osteoporosis in children/adolescents is extremely important not only to improve bone quality but also because, if left untreated, could lead to severe and precocious loss of bone mass. Studies in growth hormone (GH) deficient adults, in turn, have shown that treatment with GH produce bone mass gain and improve the occurrence of both bone formation and reabsorption.

The authors present the following case report of a 16 year old Caucasian female with congenital blindness. Suspected of having short stature at the age of 14 she was referred to the endocrinology department for further examination. Eutocic delivery at the gestational age of 39 weaks, A.I 8/9, W=2850 gr, L=47 cm; PC=35 cm. Breast-fead during the first 3 months. Food diversification from the 4^th month, without intolerance. Growth retardation detected at the age of 2 (−3 sds) and delayed psycho-motor development. Puberty arousal at 12, with menarche at 14. oligoamenorrhea since then. Physical examination: bilateral blindness, W=25.7 Kg (−3 sds), H=128 cm (−3 sds); BMI- 15.6 Kg/m2. Bone age exam showed closed cartilage. Laboratory findings revealed: IGF1<20 ng/mL (163–972); GH<0.1 ng/mL, TSH 4.3 mU/L (0.1–4.0); PRL 9.8; urine density - 1014; CRH test - basal/pick - ACTH 16.6/51 pg/mL and cortisol 10.6/22.8 ug/dL; LHRH test – basal/pick – LH 9.8/89 UI/L and FSH 9.2/20.4 UI/L). The MRI showed hypophysis and pituitary stalk hypoplasia with ectopic location of the posterior lobe; along with bone malformation of the cranial – vertebral gynglymus. The osteodensitometry of the lombar spine revealed severe osteoporosis (Z score of −4.3). Etthynylestradiol 15 mcg/ gestodene 60 mcg and alendronate 70 mg/weekly were started. Reevaluation of bone density after one year showed stable density. Although in Portugal GH treatment is not available for use in adults we ask…

Should this patient be further considered for GH treatment?