0023—Growth Hormone Treatment of a Child with Growth Hormone Deficiency, Type I Diabetes, and Chronic Steroid Use

Abstract

P.K. is 14 years 4 months old, has had severe steroid-dependent asthma since infancy, and was diagnosed with type I diabetes at the age of 3 years. He has been hospitalized numerous times for his asthma, or diabetes, or both conditions. A review of our hospital records notes at least 35 admissions (not counting ER visits) in the past 4 years, with at least one to two intensive care unit interventions yearly. His growth has been consistently under the 5th percentile since he was 5 years old, which is attributed to his suboptimal diabetes control (glycosylated hemoglobin [HgA1C], 8.5–9%; normal, <5.8%) and frequent high-dose prednisone therapy administered orally. In 2000, his short stature became a major issue with P.K. and his family, and they requested a workup and possible therapy. Growth hormone (GH) testing was delayed because of numerous hospitalizations, but it was completed in 2005. He is GH-deficient and recently started GH therapy.