I CONGRESO DIGITAL AEP. Libro de comunicaciones y casos clínicos

225 ISBN: 978-84-09-24491-1 ÁREA DE ESPECIALIDAD • ENDOCRINOLOGÍA ASOCIACIÓN ESPAÑOLA DE PEDIATRÍA Short stature and obesity: what’s the cause? Catarina Neto Viveiros, Ivete Domingues Afonso, Raquel Azevedo Alves, Patricia Oliveira Santos, Filipa Vasconcelos Espada, Marcelo Da Fonseca Hospital Pedro Hispano, Matosinhos, Portugal INTRODUCCIÓN Human growth is dependent on multiple intrinsic and extrinsic factors. Growth disorders, even when subtle are usually a cause of concern for parents and pediatricians. Short stature and obesity are frequent complaints in an endocrinology appointment. Re- search for pathologic causes is essential as well as proper treatment. RESUMEN DEL CASO Male adolescent, 13 years and 8months old, was refe- renced to endocrinology consultation due to obesity and short stature. He had no relevant personal or fa- mily history. Size at birth suitable for gestational age. Midparental height 179 cm (P 50-75). Physical exa- mination: Body Mass Index (BMI) 31.1 kg/m2, height 144 cm (P <3), facio-troncular obesity, acanthosis nigricans and Tanner scale 2. Laboratory findings: thyroid-stimulating hormone >500 000 uUi/ml and positive antithyroperoxidase and antithyroglobulin antibodies. Total cholesterol 310 mg/dl and LDL 226 mg/dl. He started therapy with levothyroxine, with progressive adjustments until normalization of thyroid function. We noted improvement of the lipid profile and weight loss (BMI 28.19 kg/m2). However, height velocity was less than expected so complementary study of short stature was car- ried out: bone age delayed in 4 years, serum insu- lin-like growth factor 1 (IGF-1) level 107 ng/ml (N 211-512 ng/ml), clonidine stimulation maximum 0.5 ng/ml, glucagon test with priming maximum 0.65 mg/dl. Magnetic resonance imaging (MRI) of the brain was normal. We admitted growth hor- mone deficiency and the protocol of growth hor- mone was started. At 15 years and 9 months, 12 months after the beginning treatment with growth hormone (while maintaining levothyroxine), height was in P3-10, with a height velocity of 10.8 cm/y, BMI 24.5 kg/m2 and Tanner scale 3. 13 years and 8 months old. Height/weight evolution.