case_images: PMC6220405_01
case_images: Patient's weight for age and height for age on CDC growth charts after being 17 years old.
case_images: CRIE2018-4748750.001.jpg
case_images: PMC6220405_01_CRIE2018-4748750.001.jpg
case_images: fig1
case_images: TSH and GnRH deficiencies. Though GHD was suspected based on height (z-score of - 3.1; see Figure 1), treatment had not been initiated based on the initial management focus being to treat her medulloblastoma.
case_images: Slides from the patient's liver biopsy. (a) Low power liver section, (b) ballooning hepatocyte degeneration, a feature of hepatic cell death, and (c) intervening fibrous tissue seen as a terminal stage of liver injury. These all constitute steatohepatis with moderate steatosis.
case_images: CRIE2018-4748750.002.jpg
case_images: PMC6220405_01_CRIE2018-4748750.002.jpg
case_images: fig2
case_images: Liver biopsy showed steatohepatitis with bridging fibrosis (Figure 2).
case_images: The patient's Quality of Life (QoL) scores with time. QoL-AGHDA: Quality of Life-Assessment of Growth Hormone Deficiency in Adults. QLS: Quality of Life Satisfaction. 1A decrease in score for QoL-AGHDA indicates an improvement in QoL-AGHDA, whereas an increase in QLS indicates an improvement while taking GH therapy.
case_images: CRIE2018-4748750.003.jpg
case_images: PMC6220405_01_CRIE2018-4748750.003.jpg
case_images: fig3
case_images: She was now able to work for 20 hours weekly without becoming fully exhausted and her Quality of Life-Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA) and Quality of Life Satisfaction (QLS) scores, both questionnaire-based, improved (Figure 3).