Multifocal chloromas preceding acute myelogenous leukemia.

stimulatory investigations revealed persistently elevated immunoreactive GH levels. After glucose load, GH was adequately suppressed. It would have been ideal to measure IGF-1 levels but due to nonavailability of this assay here, it could not be done. A similar case of GH insensitivity syndrome was reported earlier(2). GH insensitivity syndrome encompasses a range of etiologies one of which is GH receptor deficiency (GHRD). The reported patients, now exceeding 150, with GHRD are predominantly of Mediterranean origin(3). A remarkable concentration of GHRD was reported from an inbred Caucasian population in southern Ecuador predominantly affecting females(4). Elucidation of molecular mechanisms responsible for Laron syndrome has been rapid, and promises to be helpful in genetic counseling of the affected families.