If the condition is untreated, growth continues at between fifty and sixty per cent of the normal rate. Body and facial features remain immature, and the patient is usually fat due to the absent lipolytic action of GH (Fig. 2.11). Body proportions and mental development are normal and consistent with chronological age. Investigation of these children shows retarded bone age in parallel with their height. GH secretion is deficient on provocative challenge (such as insulin-induced hypoglycaemia or arginine stimulation). In adults, both abnormal fat distribution and reduced exercise capacity can be reversed with GH therapy (see below) .
