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Yan Wu, [email protected] Disclaimer All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers

In many patients with severe primary IGF-I deficiency (SPIGFD) defined by low IGF-I (less than 3 SDS or the 2.5 th percentile), severe short stature (Height SDS less than 3), normal GH secretion and absence of acquired insensitivity to GH (discussed below) genetic defects may be absent

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