Abstract
GHD and pubertal delay are known to occur following CI in children. We report 3 girls who developed precocious puberty and GHD after receiving CI. The clinical data are shown below.
Patients #1 and #2 grew at annual growth rates of 6.5 and 6.3 cm before menarche. GHD was diagnosed after menarche in both. Pt #1 received human growth hormone between the ages of 9.5 and 11.8. Their predicted adult heights (PAH) (method of Greulich and Pyle) were 141 and 142 cm. Pt #3 evaluated at the age of 6.5 was growing at 6.7 cm/yr. Her serum estradiol was 1.0 ng/dl and her peak serum LH and FSH following LHRH administration (100 μg) were 11.9 and 17.1 mIU/ml. Her PAH was 149 cm. No demonstrable cranial, adrenal or ovarian cause for precocious puberty was found in any of the patients.
We report here evidence that CI can result in both hypothalamic pituitary hypofunction and hyperfunction in the same individual. Finding “normal” growth rates in such patients does not obviate the need for evaluating their growth hormone dynamics.
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Rapaport, R., Schenkman, S., Churchill, J. et al. 59 PRECOCIOUS PUBERTY AND GROWTH HORMONE DEFICIENCY (GHD) FOLLOWING CRANIAL IRRADIATION (CI). Pediatr Res 19, 613 (1985). https://doi.org/10.1203/00006450-198506000-00079
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DOI: https://doi.org/10.1203/00006450-198506000-00079