Endocrine Abstracts

We present the case of a 33-year-old male who addresses an endocrinology service for the first time in May 2014 for marked asthenia, drowsiness, muscular aches, and a delay in growing. The physiological exam showed difficulties in communicating and relation with the others based on his own negative image of himself, lack of self- trust, auto-isolation tendency, state of depression. We raised the suspicion of a panhypopitutarism confirmed by the lab exams that describe a somatotrope, tireotrope, corticotrope and gonadotrope deficit. The patient doesn’t associate diabetes insipidus. In this conditions the patient associates a delay of bone age that is of approximately 14 years with a height at −1 S.D. for adult age (height velocity the last 2 years as declared was approximately 15 cm per year) and also a poor bone mass density z-score=−1.8. The IRM showed an empty sella. We initiated treatment with prednisolone on which the blood pressure raised till 110/70 mm/Hg, thyroid hormones and testosterone to complete his bone grow after which we will be placing him on growth hormone substitution for adults. After 6 months of treatment his general estate improved: his blood pressure raised, hair and skin improved, started puberty, but what was amazing were the changes in his emotional area, so the repeated physiological exam showed improved self-image, absence of depressive estates, increased capacity of communication, relating availability and most of all … the appearance of a smile.