[Panhypopituitarism in one identical twin: the effect of hormone replacement].
BACKGROUND
Panhypopituitarism in childhood is rare. It is even rarer if the disorder appears in a boy with an identical but healthy twin brother. In such a patient it is useful to study the consequences of the hormone disorder and the effect of hormone replacement.


METHODS
A 6-year-old boy saw a paediatrician because of short stature. He was much shorter than his identical twin brother and he had more abdominal fat mass and a smaller penis. Laboratory tests identified hypothyroidism of central origin, in combination with hypocortisolism and growth hormone deficiency. Hormonal replacement resulted in an improvement in growth rate. At the age of 15 years, testosterone therapy was introduced because puberty had not occurred and his growth rate was low. Finally the patient grew a few centimetres taller than his twin brother.


CONCLUSIONS
In the first year of life, panhypopituitarism has no negative consequences for growth. After this point, growth is clearly delayed. With sufficient replacement growth can completely catch up.
Medisch Spectrum Twente, afd. Kindergeneeskunde, Enschede, the Netherlands.
Harrij
H
Del Canho
Janiëlle
J
van Alfen-van der Velden
Riwka
R
del Canho
Barto
B
Otten
D001827:Body Height / Q000187:drug effects / Q000502:physiology; D002648:Child; D006130:Growth Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D008297:Male; D011627:Puberty / Q000187:drug effects; D014430:Twins, Monozygotic
D019382:Human Growth Hormone