We present the case of an adult patient with growth hormone (GH) insufficiency and hereditary motor and sensory neuropathy type 1. Stopping GH replacement at the attainment of final height was associated with a marked reduction in power and mobility, resulting in the patient becoming wheelchair bound. GH replacement was assessed in a double-blind placebo-controlled trial. During the GH replacement arm of the trial, the patient’s mobility and independence returned to previous levels. We suggest that the indications for GH replacement in adults should take account of other medical problems, in particular neuromuscular disorders, as well as the degree of GH deficiency.

De Boer H, Blok GJ, Van der Veen EA: Clinical aspects of growth hormone deficiency in adults. Endocr Rev 1995;16:63–86.
Thorner MO, Bengtsson BA, Ho KY, Albertsson Wikland K, Christiansen JS, Faglia G, Irie M, Isaksson O, Jorgensen JO, Ranke M, Rosenfield R, Shalet S, Takano K, van der Veen EA, Weissberger A: The diagnosis of growth hormone deficiency (GHD) in adults (letter). J Clin Endocrinol Metab 1995;80:3097–3098.
Albertsson Wikland K, Rosberg S, Karlberg J, Groth T: Analysis of 24-hour growth hormone profiles in healthy boys and girls of normal stature: Relation to puberty. J Clin Endocrinol Metab 1994;78:1195–1201.
Rahim A, Toogood AA, Shalet SM: The assessment of growth hormone status in normal young adult males using a variety of provocative agents. Clin Endocrinol (Oxf) 1996;45:557–562.
Svensson J, Johannsson G, Bengtsson BA: Insulin-like growth factor-I in growth hormone-deficient adults: Relationship to population-based normal values, body composition and insulin tolerance test. Clin Endocrinol (Oxf) 1997;46:579–586.
Bercu BB, Diamond FB Jr: Growth hormone neurosecretory dysfunction. Clin Endocrinol Metab 1986;15:537–590.
Salomon F, Cuneo RC, Umpleby AM, Sonksen PH: Interactions of body fat and muscle mass with substrate concentrations and fasting insulin levels in adults with growth hormone deficiency. Clin Sci 1994;87:201–206.
Woodhouse LJ, Ramyar L, Weiner D, Thomas SG, Asa SL, Ezzat S: Growth hormone (GH) replacement in GH-deficient adults results in altered muscle morphology and elevated local production of insulin-like growth factor-I (IGF-I). ENDO’97. Minneapolis, Endocrine Society, 1997, p 79.
Papadakis MA, Grady D, Black D, Tierney MJ, Gooding GA, Schambelan M, Grunfeld C: Growth hormone replacement in healthy older men improves body composition but not functional ability. Ann Intern Med 1996;124:708–716.
Yarasheski KE: Growth hormone effects on metabolism, body composition, muscle mass, and strength. Exerc Sport Sci Rev 1994;22:285–312.
Johansson JO, Larson G, Andersson M, Elmgren A, Hynsjo L, Lindahl A, Lundberg PA, Isaksson OG, Lindstedt S, Bengtsson BA: Treatment of growth hormone-deficient adults with recombinant human growth hormone increases the concentration of growth hormone in the cerebrospinal fluid and affects neurotransmitters. Neuroendocrinology 1995;61:57–66.
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