In types I and II, dwarfism with child-like body
proportions and small facies in adult period. In types III and IV, the
clinical picture depends on the age of loss of pituitary function. In type
I pituitary dwarfism, the dwarfism is more extreme than in other cases,
hypoglycemia is a conspicuous feature, and the puppet facies (“baby doll
facies”) is exaggerated. In addition, development of anti-GH antibodies
occurs when exogenous GH is administered. Laron syndrome has a very similar
clinical appearance to those with isolated GH deficiency. Laron syndrome is
characterized by clinical hyposomatotropism manifested by short stature,
delayed bone age, and, occasionally, blue sclerae, and hip degeneration.
Instability of the odonto-atlantoid joint has been described. The
stimulation of growth by IGF1 treatment is prescribed, although the
long-term effects have not been documented. Delayed puberty and high-pitched voice.
In panhypopituitary dwarfism, the patients show sequential loss of anterior
pituitary tropic hormones usually in the order of GH, gonadotropin, TSH, and
adrenocorticotropic hormone (hypoglycemia, hypogonadism, hypothyroidism,
hypoadrenalism).