Long Term Follow-Up of One of The First Patients to Receive Human Growth Hormone Therapy

ABSTRACT: Objective: Treatment of growth hormone (GH) deficiency with GH extracts from human pituitary glands was introduced by Dr. Maurice Raben at Tufts New England Medical Center in 1956. We report long term follow-up of one of the first patients treated with GH. Methods: Clinical, radiographic,...

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Main Authors: Cassandra Hawco, MD, Robyn L. Houlden, MD, FRCPC
Format: Article
Language:English
Published: Elsevier 2020-09-01
Series:AACE Clinical Case Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2376060520306246
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spelling doaj-9c6d09e10d8c4e749296aed02e32fe682021-05-01T04:35:46ZengElsevierAACE Clinical Case Reports2376-06052020-09-0165e262e264Long Term Follow-Up of One of The First Patients to Receive Human Growth Hormone TherapyCassandra Hawco, MD0Robyn L. Houlden, MD, FRCPC1From the Department of Medicine, Queen’s University, Kingston, Ontario, Canada.From the Department of Medicine, Queen’s University, Kingston, Ontario, Canada.; Address correspondence to Dr. Robyn Houlden, Division of Endocrinology, Kingston General Hospital, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.ABSTRACT: Objective: Treatment of growth hormone (GH) deficiency with GH extracts from human pituitary glands was introduced by Dr. Maurice Raben at Tufts New England Medical Center in 1956. We report long term follow-up of one of the first patients treated with GH. Methods: Clinical, radiographic, and genetic data are presented. Results: A 78-year-old man presented for follow-up. He was one of the first patients to receive GH therapy from Raben in 1958. Growth was reported as normal until age 3 and then decelerated. At age 17 years, he was 129.5 cm with absent sexual development and bone age of 7 years. Treatment was initiated with desiccated thyroid and cortisone acetate for 8 months. Human GH extract was then initiated with 2 mg 3 times/week for 2 years, then 3 mg 3 times/week for 6 months, resulting in a final height of 168.9 cm. Testosterone intramuscularly every 2 weeks was added with sexual maturation over 2 years. He remained on testosterone injections until the age of 40 years, and on transdermal testosterone until the age of 50 years. At age 27 years, he was treated by Raben with human chorionic gonadotropin and menotropins for spermatogenesis restoration with successful conception by his wife. At age 78 years, pituitary MRI revealed a tiny amount of pituitary tissue within normal-sized sella turcica with absent pituitary infundibulum. A combined pituitary hormone deficiency genetic panel did not reveal any mutations. Conclusion: Sixty-two years later, the patient remains in good health and grateful to a pioneer in Endocrinology for groundbreaking therapy of short stature. The cause of his hypopituitarism remains unknown. Abbreviations: CJD Creutzfeldt-Jakob disease GH growth hormone MRI magnetic reasonance imaginghttp://www.sciencedirect.com/science/article/pii/S2376060520306246
collection DOAJ
language English
format Article
sources DOAJ
author Cassandra Hawco, MD
Robyn L. Houlden, MD, FRCPC
spellingShingle Cassandra Hawco, MD
Robyn L. Houlden, MD, FRCPC
Long Term Follow-Up of One of The First Patients to Receive Human Growth Hormone Therapy
AACE Clinical Case Reports
author_facet Cassandra Hawco, MD
Robyn L. Houlden, MD, FRCPC
author_sort Cassandra Hawco, MD
title Long Term Follow-Up of One of The First Patients to Receive Human Growth Hormone Therapy
title_short Long Term Follow-Up of One of The First Patients to Receive Human Growth Hormone Therapy
title_full Long Term Follow-Up of One of The First Patients to Receive Human Growth Hormone Therapy
title_fullStr Long Term Follow-Up of One of The First Patients to Receive Human Growth Hormone Therapy
title_full_unstemmed Long Term Follow-Up of One of The First Patients to Receive Human Growth Hormone Therapy
title_sort long term follow-up of one of the first patients to receive human growth hormone therapy
publisher Elsevier
series AACE Clinical Case Reports
issn 2376-0605
publishDate 2020-09-01
description ABSTRACT: Objective: Treatment of growth hormone (GH) deficiency with GH extracts from human pituitary glands was introduced by Dr. Maurice Raben at Tufts New England Medical Center in 1956. We report long term follow-up of one of the first patients treated with GH. Methods: Clinical, radiographic, and genetic data are presented. Results: A 78-year-old man presented for follow-up. He was one of the first patients to receive GH therapy from Raben in 1958. Growth was reported as normal until age 3 and then decelerated. At age 17 years, he was 129.5 cm with absent sexual development and bone age of 7 years. Treatment was initiated with desiccated thyroid and cortisone acetate for 8 months. Human GH extract was then initiated with 2 mg 3 times/week for 2 years, then 3 mg 3 times/week for 6 months, resulting in a final height of 168.9 cm. Testosterone intramuscularly every 2 weeks was added with sexual maturation over 2 years. He remained on testosterone injections until the age of 40 years, and on transdermal testosterone until the age of 50 years. At age 27 years, he was treated by Raben with human chorionic gonadotropin and menotropins for spermatogenesis restoration with successful conception by his wife. At age 78 years, pituitary MRI revealed a tiny amount of pituitary tissue within normal-sized sella turcica with absent pituitary infundibulum. A combined pituitary hormone deficiency genetic panel did not reveal any mutations. Conclusion: Sixty-two years later, the patient remains in good health and grateful to a pioneer in Endocrinology for groundbreaking therapy of short stature. The cause of his hypopituitarism remains unknown. Abbreviations: CJD Creutzfeldt-Jakob disease GH growth hormone MRI magnetic reasonance imaging
url http://www.sciencedirect.com/science/article/pii/S2376060520306246
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