Endocrine Abstracts

JOINT2846

Background: Growth hormone deficiency (GHD) is a condition characterized by insufficient production of growth hormone, resulting in impaired growth and development in children. Advances in therapy have introduced long-acting growth hormone analogs, such as somatrogon, offering the convenience of weekly dosing. While generally well-tolerated, localized side effects such as lipoatrophy at the site of injection, although rare, can occur. Lipodystrophy has not previously been reported as a side effect of Somatrogon therapy.

Case report: Patient Background: We report a 12-year-old boy with pyknodysostosis and growth hormone deficiency secondary to severe pituitary hypoplasia. Initially he was treated with daily Somatropin, but adherence issues led to us switching to weekly somatrogon therapy at a dose of 15 mg to address his GHD. At the start of treatment, his height SDS was -2.47.

Clinical Course: During a routine follow-up visit, regional lipodystrophy of the upper right arm was noted, characterized by a strikingly muscular appearance with prominent veins. Mother reported challenges with injection pain and the patient was insisting on using only his upper right arm for injections. No abnormalities were observed in his left arm or thighs. The appearance was attributed to repeated somatrogon injections at the same site. The importance of rotating injection sites was emphasized, and subsequently mother alternated between different anatomical sites, including the left arm and thighs.

Outcome: At his next follow-up visit, after three months, spontaneous resolution of the lipodystrophy was observed. Examination of his other injection sites showed no evidence of lipodystrophy. He continued therapy without interruption.

Conclusion: This case highlights regional lipodystrophy as a potential side effect of somatrogon therapy in a child with GHD. Timely identification and intervention through instituting proper injection site rotation led to successful resolution, without discontinuing therapy. This highlights the importance of patient and caregiver education on injection techniques to optimize therapeutic outcomes and adherence. Healthcare providers should remain vigilant for injection site reactions in patients receiving long-acting growth hormone therapies.

Acknowledgment: The authors thank the patient and his family for kindly agreeing to share their experience.