Introduction: Growth hormone deficiency (GHD) is a recognized endocrine complication among childhood cancer survivors resulting from disruption of hypothalamic–pituitary axis due to tumors, neurosurgery, or cranial irradiation. While recombinant human growth hormone (rhGH) therapy improves growth and metabolic outcome, concerns remain regarding its long-term safety with risk of tumor recurrence and secondary neoplasm. We present a case series of five paediatric oncology survivors with confirmed GHD receiving rhGH in Hospital Tunku Azizah, highlighting our clinical experience in comparison with international practice. Case: Five paediatric oncology survivors (acute lymphoblastic leukemia, craniopharyngioma, medulloblastoma, and supratentorial PNET) with GHD were commenced on rhGH therapy 2.5–5.5 years after completion of cancer treatment. All patients had significant short stature with a mean height SDS of −3.22 prior to the initiation of therapy. GHD was confirmed biochemically with low IGF-1 level and dynamic testing (peak GH 0.35–4.61 ng/mL). Among the four patients with brain tumors, two had stable residual disease while the remaining were tumor-free. rhGH therapy was temporarily ceased in two patients due to minor increment in tumor size but was successfully resumed following stabilization without further complications to date. Two patients are concurrently on pubertal induction. Most patients demonstrated catch-up growth with increased height velocity, supporting the efficacy of rhGH in this population. No secondary malignancies or significant adverse events were observed during follow-up. Conclusion Paediatric oncology survivors with GHD in this series demonstrated a favorable response to rhGH therapy, evidenced by improvements in height SDS and growth velocity, while maintaining oncological stability in the majority of cases. Our findings are consistent with international data, supporting cautious but appropriate use of rhGH in this population. Careful patient selection and close multidisciplinary monitoring remain essential.
Child ; Neoplasms ; Growth Hormone ; Survivors

Introduction: Short-term fasting may influence intraocular pressure (IOP) due to alteration of fluid (total body water; TBW, and water intake) and fat (total body fat; TBF). This study aimed: i) to compare IOP values within and between, fasting and non-fasting periods; and ii) to assess the association between IOP and, TBW and TBF. Methods: Thirty healthy participants aged 21.8±1.1 years were assessed on two different periods (fasting vs. non-fasting). During each period, the IOP, TBW and TBF values were assessed for four times (morning, afternoon, evening, late-evening). The IOP was measured using AccuPen® tonopen, while TBW and TBF were assessed by using a Tanita body composition analyser. Results: During fasting, the IOP value in the afternoon (14.53±2.33 mmHg) was significantly higher than in the evening (12.43±2.73 mmHg, p=0.009) and late-evening (12.60±2.44 mmHg, p=0.003). No significant difference in IOP was observed during non-fasting period. The mean of IOP in the evening was significantly lower during fasting compared to non-fasting (12.43±2.73 mmHg vs 13.75±2.53 mmHg, p=0.044). The IOP and TBW were negatively correlated (r=-0.268; p=0.011) during non-fasting and showed no association during fasting period. There was no significant correlation between IOP and TBF during both fasting and non-fasting periods. Conclusion: IOP reduction during short-term fasting, together with the no association with TBF and TBW suggested that IOP is an independent factor that reduces during fasting in healthy population.