Secondary Growth Hormone Deficiency That Developed into Cirrhosis after Several Years of Interrupted Growth Hormone Replacement Therapy.

A patient with secondary panhypopituitarism developed cirrhosis following discontinuation of growth hormone replacement therapy.

• The patient had been receiving hormone replacement therapy for secondary panhypopituitarism.
• GH replacement was discontinued after the patient developed diabetes, as GH replacement was deemed contraindicated.
• Liver damage progressed over several years following diagnosis of fatty liver, ultimately leading to cirrhosis.
• Common factors linked to cirrhosis were excluded, implicating GH deficiency as the primary contributor.

GH deficiency was identified as the primary contributor to the development of cirrhosis in this patient.

• The progression from fatty liver to cirrhosis occurred over several years during the period of GH deficiency.
• Common etiological factors linked to cirrhosis were systematically excluded.
• The authors attributed the liver disease progression to GH deficiency resulting from the interruption of GH replacement therapy.
• The case suggests a causal relationship between prolonged GH deficiency and progressive liver disease including cirrhosis.

Clinicians should carefully consider the potential implications of GH replacement therapy when treating patients with GH insufficiency and diabetes.

• GH replacement therapy had been previously discontinued in this patient due to the development of diabetes, as it was deemed contraindicated.
• The case highlights a clinical dilemma: GH replacement may be relatively contraindicated in diabetes, yet GH deficiency may contribute to serious liver disease.
• The authors conclude that the potential risks of withholding GH replacement, including liver disease progression, should be weighed against the risks of continuing it in diabetic patients.
• This case report emphasizes the need for careful clinical decision-making regarding GH replacement in patients with comorbid conditions.