SUN-046 - Heterogeneity In Severe Adult Growth Hormone Deficiency

We have shown three cases of different type of severe GH deficiency.
Cause of severe GH deficiency was mainly hypothalamus-pituitary tumors such as pituitary adenoma and craniopharyngioma. On the other hand, appearing of GH deficiency in the patients with none of apparent past history should be keeping in mind. Case 1: Forty-five years-old female complaint liver dysfunction. At 18 years old, she had undergone the operation and radiation therapy two times for suprasellar meningioma. At 43 years-old general fatigue and liver dysfunction were appeared, suggesting that pituitary function tests were necessary. Finally, severe GH deficiency and fatty liver were diagnosed. Case 2: Fifty-five years-old male complaint anorexia, general fatigue, depression and weight loss with fatty liver by a family doctor before 3 months. Increasing of FT3 and FT4 and decreasing of TSH without tenderness of thyroid were suspected as painless thyroiditis. Slightly atrophic pituitary gland were observed without pituitary tumor showing low plasma cortisol and ACTH diagnosed as anterior hypopituitarism and severe GH deficiency after examination of ITT and GHRP-2.　Treatment with somapacitan increased muscle volume and body weight. Case 3: Fifty-one years-old female (154 cm, 77.5kg, BMI 32.6) complaint general fatigue, depression, and increasing of body weight. She had been suffered from general fatigue for 7 years, and 12 kg increasing of her body weight for 1 month in addition to depression, and decreasing of cognitive function. Biochemical data indicated fatty liver and diabetes mellitus, and admitted in order to clear the pathophysiology and treatments. Her biochemical data and brain MRI indicated fatty liver, abnormal lipid metabolism and diabetes mellitus with obesity, and normal findings of pituitary gland and normal function of anterior pituitary function except for GH secretion, respectively. However, ITT and GHRP-2 test showed severe adult GH deficiency, and then somapacitan, SGLT-2 inhibitor and Tirzepatide treatments improved cognitive function (HDS-R: 5 to 28 points), decreasing in body weight and diabetes mellitus. These different three cases indicated that patients with severe GH deficiency in early stage should be found and treatment with replenishment of growth hormone in early stage to protect development of lifestyle-related diseases such as fatty liver, glucose intolerance, obesity, depression and the disturbance of cognitive function.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*