The patient is a 14 year-old male with growth hormone deficiency followed by the doctor who had an extensive evaluation that included the following:

• At 11 years of age, normal thyroid function and low IGF-1 of 101. 
• At 11-6/12, IGF was low, but with a peak growth hormone of 5.9.
• At 11-7/12 clonidine test with a peak growth hormone of 10.3. 
• At 11-9/12 insulin-induced growth hormone stimulation with a peak of 10.2 and nadir glucose of 28. 
• At 13-11/12 cortisole 17.4, free T4 1.1 and he is on growth hormone treatment.  Genotropin 2.2 mg six days a week (0.39 mg/kg/week).  Growth velocity is 8.6 cm/yr.  His growth chart indicates a good response to growth hormone treatment.

PHYSICAL EXAMINATION:

His height is 154.1 cm, which is at 10^th to 25^th percentile and weight is 48.3, kilos which is at the 25^th to 50^th percentile.  He is Tanner stage II to III for genitalia and pubic hair.  Testis is 1.8 x 3.5 on the right and 2 x 3.5 on the left and a stretched penile length is 10 cm.

ASSESSMENT AND PLAN:

The patient has growth hormone deficiency with a good response to growth hormone treatment.  We will continue the same dose of 2.2 mg six days a week.  We would like to check IGF-1.  We will review all possible complication in human growth hormone treatment and we would like to see him in six months.