title: Growth hormone therapy in a girl with Turner syndrome and diabetes type 1 - case report.
abstract: BACKGROUND
  The studies indicate the complex etiology of abnormal glucose metabolism in the Turner syndrome (TS). In the light of these carbohydrate disorders a therapy with recombinant growth hormone (rGH) in TS may be associated with complications, as growth hormone has a diabetogenic potential.
  
  
  METHODS
  Perinatal history is unknown since the patient was adopted at the age of 4 years. At 11 years old, due to typical phenotype, TS was diagnosed. The karyotype was 45,X[43]/46,X,i(X)(q10)[7]. At the same age, basing on laboratory results, insulin dependent diabetes was diagnosed and the conventional insulin therapy was initiated. During the hospitalization, at the age of 12 years, the patient was 123.5cm (-4.4SD). At the same age rGH tre-atment was initiated, with the dose 0.045 mg/kg/d. After 3 months of therapy the height velocity rose to 8.2 cm/ year. At the age of 13 years, substitution with 17β-estradiol was started. After 3 years and 4 months the growth hormone treatment was stopped because of poor height velocity. The final height of the patient was 140 cm (-4,OSD). Two years after the end of rGH treatment the height was 141.2 cm. After termination of rGH treatment the need for daily insulin dose decreased from 50-60U/d to 38-44U/d.
  
  
  CONCLUSIONS
  The decision of rGH therapy in TS with diabetes is certainly difficult. While starting the growth hormone treatment the clinician must keep in mind the risk of metabolic complications, but also the awareness that gives the patient a chance to improve the final height. In terms of the proper psycho-emotional development the reduction of growth deficit is very important.
authors.affiliation: Department of Pediatric Endocrinology and Rheumatology, Poznan University of Medical Sciences.
authors.forename: Monika
authors.initials: M
authors.lastname: Obara-Moszynska
authors.affiliation: Sciences Student Scientific Group of Pediatric Endocrinology, Poznan University of Medical Sciences.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Banaszak
authors.affiliation: Department of Pediatric Endocrinology and Rheumatology, Poznan University of Medical Sciences.
authors.forename: Marek
authors.initials: M
authors.lastname: Niedziela
mesh_terms: D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D016896:Treatment Outcome; D014424:Turner Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology
keywords: Turner syndrome; diabetes mellitus type 1; recombinant growth hormone