Final height in isolated GH deficiency type 1A: effects of 5-year treatment with IGF-I

Data concerning final height (FH) in isolated growth hormone deficiency typ e 1A (IGHD1A) are scanty and controversial. In this paper we report the FH outcome of two girls with IGHD1A who were treated either with GH only (firs t patient) or with GH during the first 8 years and successively with IGF-I (second patient). In the first patient, FH was only slightly subnormal and slightly taller with respect to target height (TH). Surprisingly, FH was se verely subnormal and very far from TH in the patient who underwent IGF-I th erapy for >5 years: an auxological outcome similar to the one recently repo rted in the only two cases in the literature of patients with IGHD1A who ha ve been treated with IGF-I until near FH achievement, We conclude that IGHD 1A could have a very heterogeneous phenotypic expression in terms of FH and that IGF-I therapy, even though initiated some years before puberty onset and prolonged for more than 5 years, may not be able to ensure the normaliz ation of height prognosis and the achievement of an FH close to TH.