1998 Volume 7 Issue 1 Pages 17-21
We reported a tall Japanese girl who was treated with a somatostatin analog (SA: octreotide acetate). The patient was an 11 years and 10 months old girl who was 171.0 cm tall (+3.58 standard deviations: SD), and whose father and mother were 176.0 cm and 171.0 cm tall, respectively. Although menarche had not occurred on admission, her pubertal development had reached Tanner stage II (breast II, pubic hair II) and the bone age was 11.5 years. The serum levels of estradiol and insulin-like growth factor I (IGF-I) and the early morning urinary growth hormone (U-GH) level were 33 pg/ml, 480 ng/ml, and 58 pg/mg creatinine, respectively. The peak GH responses to insulin, glucagon-propranolol, and GH-releasing hormone were 22.5, 54.2, and 21.9 ng/ml, respectively. There were no abnormal findings in the pituitary gland on magnetic resonance imaging. We diagnosed her as being of familial tall stature and started treatment with SA at a dose of 250 μg per day (100 μg in the morning and bedtime plus 50 μg in the evening) after informed consent was obtained from her and her parents. This treatment resulted in suppressing the serum level of IGF-I and the U-GH level to 180 ng/ml and 18 pg/mg creatinine, respectively, after 10 days. Bone maturation was accelerated by 42 months during 26 months of treatment. Her final height was suppressed to 173.8 cm after treatment, while her predicted final height was above 180 cm. No side effects such as impaired glucose tolerance, hypothyroidism and physical discomfort were observed. Although a slight decrease in spinal bone mineral density was observed during the treatment period, an increase in bone mineralization was observed 6 mon after the cessation of treatment. In conclusion, SA was effective and safe for reducing the increase in height in this present case.
