Report of optic disc edema in growth hormone insensitive patients after treatment with insulin-like growth factor-I

Intracranial hypertension with papilledema has recently been reported with growth hormone administration. We present the case of a 14 year old female with growth hormone insensitivity syndrome (GHIS), who developed optic disc edema (ODE) within 30 days of the initiation of therapy with recombinant IGF-I (insulin-like growth factor I) (120 μg/kg BID). Symptoms may be intermittent, and thereby unreliable indicators of ODE. At least 5/131 patients with GHIS who have received IGF-I have developed this condition. Because of the high risk for developing ODE in this patient population, serial funduscopic examination is warranted for children receiving IDF-I.