Abstract
Study of a psychosocial dwarf with initial GH deficiency reveals that the dwarfism was not due to caloric deficit nor inability to generate SM in response to GH release. We present data on a 7 yr. old boy with a severe form of psychosocial dwarfism (PSD), who began a period of marked catch-up growth 3 weeks after admission (growth velocity 3 cm/month). During the period of poor growth the mean caloric intake was 1595 cal/day, in the period of catch-up growth it was 1504 cal/day. Since the weight increased in the period of catch-up growth the caloric intake per kg bodyweight actually decreased. The maximum growth hormone response during combined L-DOPA-ITT rose from 5.9 ng/ml to 13.6 ng/ml in the phase of catch-up growth. Somatomedin which was in the hypopituitary range of 0.59 U/ml rose concomitantly to a normal value of 0.84 U/ml. With separation from his favorite nurse his growth velocity dropped while in the hospital to 0.4 cm/month accompanied by an inadequate growth hormone release upon stimulation (max. GH 6.9 ng/ml). The caloric intake remained unchanged, with the return of his favorite nurse he resumed his previous growth velocity of 3 cm/month and stimulable growth hormone rose to 15 ng/ml. We conclude that growth failure in PSD is not due to caloric undernutrition but to defective GH release and inadequate SM generation which corrected with removal from the family milieu.
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Saenger, P., Levine, L., New, M. et al. PSYCHOSOCIAL DWARFISM: NORMAL SOMATOMEDIN (SM) GENERATION. Pediatr Res 8, 374 (1974). https://doi.org/10.1203/00006450-197404000-00207
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DOI: https://doi.org/10.1203/00006450-197404000-00207
