Reversible Injection-Site Lipoatrophy Induced by Long-Acting Growth Hormone (Somatrogon) in Pediatric Growth Hormone Deficiency: A Case Series

Recombinant human growth hormone (GH) has been utilized for nearly four decades in the management of growth hormone deficiency (GHD); however, adherence to daily injections may be suboptimal in children. To overcome this limitation, long-acting GH analogues have been developed. Somatrogon, a once-weekly formulation and the first long-acting GH approved for use in Turkiye, is indicated for children aged ≥3 years with GHD. Clinical trials have demonstrated that adverse events are predominantly mild, with injection-site pain being the most frequently reported. Lipoatrophy associated with somatrogon therapy has been documented only once previously, rendering the present series the first to describe multiple cases. We report three pediatric patients (two males and one female; aged 7.2, 13.2, and 6.9 years, respectively) who developed localized lipoatrophy at upper-arm injection sites during somatrogon therapy. The condition emerged after 9 months in two patients and after 12 months in the third. All had a history of repeated injections at the same anatomical sites. No systemic adverse effects were observed, and growth responses remained appropriate. Treatment was continued while injection sites were rotated to the thighs and abdomen. Complete resolution of lipoatrophy was achieved within three months, with no recurrence during follow-up.