A 15-year-old boy with achalasia of the oesophagus is described in whom growth retardation was the presenting and misleading symptom. Growth hormone (GH) and insulin-like growth factor-I secretion were decreased but GH therapy was unsuccessful. After pneumatic dilatation of the oesophageal sphincter catch up growth occurred.
Conclusion: In children with inconclusive results of GH stimulation tests and unresponsiveness to GH treatment, rare causes of growth retardation due to malnutrition or malabsorption should be considered.