GOOD GROWTH DESPITE VERY-LOW LEVELS OF INSULIN-LIKE GROWTH-FACTORS

A 12.5-year-old girl presented with short stature. Insulin-like growth factor 1(IGF-I) and insulin- like growth factor binding protein (IGFB P-3) were below the 0.1 percentile. Growth hormone provocation tests d isclosed normal responses to L-arginine and insulin-induced hypoglycae mia. A huge benign mesenteric cyst: was discovered by abdominal ultras ound and completely removed. Subsequently, the girl showed a marked ca tch-up growth; however, IGF-I and IGFBP-3 remained below the 0.1 perce ntile. Conclusion These observations imply that growth may take place even with very low levels of insulin-like growth factors. The interpre tation of low IGF-I and IGFBP-3 levels in short children still require s good clinical judgement and basic knowledge of their biological acti on.