title: Increased prevalence of growth hormone deficiency in patients with vernal keratoconjuntivitis; an interesting new association.
abstract: BACKGROUND
  Vernal keratoconjunctivitis (VKC) is a chronic conjunctivitis that mainly affects children living in temperate areas. The notable difference between genders and VKC's resolution with puberty have persistently suggested a role of hormonal factors in VKC development.
  
  
  OBJECTIVE
  To describe six cases of males with VKC and growth hormone deficiency (GHD) reported as a long-term follow-up during rhGH treatment.
  
  
  METHODS
  Six consecutive male patients (median age at GHD diagnosis 9.7, range 7.9 to 13.1 years) with VKC, were recruited from July 2005 to July 2013 at the Paediatric Endocrinology Unit of Anna Meyer Children's Hospital in Florence, Italy. In these patients, anthropometric data were collected periodically. In three of these patients, data were collected to near-adult or adult height.
  
  
  RESULTS
  Familial history was uneventful for all patients. The target height was normal, ranging from 0.65 standard deviation scores (SDS) to 2.01 SDS. The patients showed a normal birth-weight (from -1.21 to 1.35 SDS) and birth-length (from -0.93 to 1.21 SDS). At GHD diagnosis, all of the patients exhibited demonstrated important growth retardation (from -2.05 to -2.78 SDS). Plasmatic concentrations of IGF-1 and IGFBP-3 were low (from -1.85 to -3 SDS and from -1.81 to -2.76 SDS, respectively). GH stimulation tests showed classic GHD symptoms in all of the patients. Pubertal onset was normal. All of the patients treated with rhGH responded well to rhGH treatment. Adult height, evaluated in three patients, was in accordance with their target height.
  
  
  CONCLUSIONS
  To our current knowledge, we have described for the first time six patients affected by VKC with GH deficiency, in some of whom we performed a long-term follow-up to adult height. Further studies will be needed to establish whether GHD may be a common feature of VKC patients. Nevertheless, it appears to be useful to carefully follow statural growth of VKC patients, while the possibility of a GH deficiency must to be taken into account in the presence of growth failure.
authors: Department of Health's Sciences, University of Florence,Florence, Italy.
authors: Stefano
authors: S
authors: Stagi
authors: Department of Health's Sciences, University of Florence,Florence, Italy.
authors: Neri
authors: N
authors: Pucci
authors: Department of Health's Sciences, University of Florence,Florence, Italy.
authors: Laura
authors: L
authors: di Grande
authors: Clinical Ophthalmology Unit; Anna Meyer Children's University Hospital; Florence, Italy.
authors: Cinzia
authors: C
authors: de Libero
authors: Clinical Ophthalmology Unit; Anna Meyer Children's University Hospital; Florence, Italy.
authors: Roberto
authors: R
authors: Caputo
authors: Department of Health's Sciences, University of Florence,Florence, Italy.
authors: Stefano
authors: S
authors: Pantano
authors: Department of Health's Sciences, University of Florence,Florence, Italy.
authors: Salvatore
authors: S
authors: Seminara
authors: Department of Health's Sciences, University of Florence,Florence, Italy.
authors: Maurizio
authors: M
authors: de Martino
authors: Department of Health's Sciences, University of Florence,Florence, Italy.
authors: Elio
authors: E
authors: Novembre
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D001827:Body Height / Q000187:drug effects; D002648:Child; D003233:Conjunctivitis, Allergic / Q000175:diagnosis / Q000453:epidemiology*; D006130:Growth Disorders / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency* / Q000627:therapeutic use; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011994:Recombinant Proteins / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D011994:Recombinant Proteins; D019382:Human Growth Hormone