Although the favorable effect of GH in improving oxygenation in HPS has only been observed in those secondary to hypopituitarism (2, 3, 5, 6, 10), it is worthwhile to explore the potential effectiveness of GH in patients with HPS of alternative etiologies, considering recent reports indicating that GH replacement therapy may have a positive impact on non-alcoholic fatty liver disease (21). This evidence concerns the gene GH1 and metabolic dysfunction-associated steatotic liver disease.