A 16-year-old girl presents with poor growth for four years. Her growth and development were normal before this, and her appetite and food intake remain satisfactory.

At age 12, she was a passenger in a motor vehicle collision, where she suffered a moderate traumatic brain injury (GCS of 12), requiring hospitalization for around a week. There were no intracranial hemorrhages and she did not require neurosurgical intervention.

Her family history is unremarkable. Her performance at school is satisfactory. She has not attained menarche yet. A complete blood count, metabolic panel, liver function tests, urinalysis, and ESR are all within normal limits.