ACQUIRED HYPOPITUITARISM AFTER REYE'S SYNDROME

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Growth failure after Reye's Syndrome was studied in a 14 year old white male. He had Reye's Syndrome at age ten years and also had loss of vision, which later improved considerably in the right eye. After recovery from Reye's Syndrome, he had no increase in linear growth during the following four years. From 75th percentile, his height dropped to below 5th percentile. His sexual maturation was in Tanner Stage I and funduscopic examination revealed optic atrophy on the left side with right disc being normal. He was admitted for complete neuroendocrine workup at this time which showed a low Somatomedin-C level, subnormal growth hormone response to arginine-glucagon stimulation test (maximum growth hormone level of 1.2 ng/ml), subnormal TSH response to TRH stimulation (maximum TSH level of 5 μIU/ml) and a normal metyrapone test. Serum LH and FSH were 7 and < 1 MIU/ml respectively. Urinary sp.gr. and osmolality were within normal limits indicating normal posterior pituitary functions. CT scan of the head showed small old infarct in right occipital lobe with slightly prominent CSF space. The bone age was compatible with his height age. Subsequently, patient has been started on Human Growth Hormone and levo-thyroxine treatment and response has been satisfactory. These results indicate hypopituitarism and optic atrophy following Reye's Syndrome. These complications after Reye's Syndrome have not been reported before. The patients with Reye's Syndrome should be monitored for subsequent growth failure and visual complications.