GH1 and nutritional deficiency disease: Malnutrition, defined as weight/expected weight-for-height ratio <80%, is described in 70% of children with SRS and a body mass index (BMI) SD score (SDS) of <−2 in 61%.5 Absence of catch-up growth results in reduced adult height, although height can be improved by treatment with growth hormone (GH).6 Developmental delay is reported in some cases and varies from mild transient speech or motor delay to more severe developmental and behavioural phenotypes.5 7