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The primary underlying pathomechanism is most likely a decreased hepatic GHR expression related to insulin deficiency, resulting in GH-resistance and impaired hepatic IGF-1 synthesis, which stimulates pituitary GH-secretion by a feedback mechanism [188, 189]

10.1016/0003-9861(88)90487-0 6 AmjadS.NisarS.BhatA

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Severity Of Condition: The severity and depth of discolouration can directly determine the cost