Bone scan and IGF1 deficiency: Case report

Growth delay in adults with GH (growth hormone) or insulin-like growth factor 1 (IGF1) deficiency is often associated to low bone mineral density (BMD), osteoporosis and a higher risk of fractures (Tritos et al., 2011 [1]; Mister et al., 2001 [2]; Bex et Bouillon, 2003 [3]). However to date, the risk of fractures in children with OH or IGF1 deficiency is not clearly evaluated (Hogler and Shaw, 2010 [4]). This is the case of a young woman aged 21, with a syndrome including a severe mental, growth and weight retardation (-4 SD), facial dysmorphism and partial epilepsy, who recently presented walking and muscle strength loss, without history of trauma. Bone scan revealed several hot spots related to cortical bone fractures and biological data showed an IGF1 deficiency. Through this case, we discuss the role played by OH and IGF1 in bone growth, and the basic procedures to follow in children when measuring BMD with dual absorptiometry X ray technique (DXA). (C) 2012 Elsevier Masson SAS. All rights reserved.