HYPOPITUITARY DWARFISM The Importance of Early Therapy

Two siblings with hypoglycemia had from early infancy retardation of growth which seemed to be due to isolated deficiency of somatotropin. The father had diabetes mellitus which may be of etiologic significance. They have been followed from birth to the ages of 6 and 7 1/2 years respectively. Experience with long-term therapy with HGH, 2 mg three times weekly, from the age of 3 1/2 and 2 years is reported. A purified HGH preparation which is supposed to contain only the somatotropin proper, seems to be preferable. A reduction of the HGH dosage to 1 mg three times weekly resulted in a marked reduction in height increments, and almost no growth was observed in the short periods without therapy. Total growth during a 4-year-period was 29.5 and 32.5 cm respectively. However, the therapy was probably initiated too late and the height continues to be far below the 2.5 percentile, particularly in the older child. The importance of an adequate therapy from early infancy in the more severe cases of hypopituitary dwarfism is stressed. Attention is drawn to the hematological aspect of hypopituitary dwarfism, and the increased iron requirement during the initial period with catchup growth.