Final Height in Children with Growth Hormone Deficiency

Abstract

Forty-six patients (28 boys, 18 girls) were treated with growth hormone (GH) for short stature. Twenty-eight patients had total growth hormone deficiency (GHD), 12 partial GHD and 6 patients had short stature without GHD. Brain tumours were the cause of GHD in 8 patients and multiple pituitary hormone deficiency was present in 9 children. All patients received GH with subcutaneous injections only, 6-7 times/week. Mean final height for all patients was -1.11 SDS and was similar in boys ( 1.09 SDS) and girls (-1.13 SDS). Target height SDS was -0.80 SDS in 42 patients, comparing favourably with a final height SDS of-1.05. Similar results were obtained in all patient sub-groups. Height velocity during the last year of therapy was between 2.1 and 9.9 cm/ year in 34 patients and below 2 cm in 12 patients. As further growth is to be expected, target height will probably be reached by most patients.

Final Height in Children with Idiopathic Growth Hormone Deficiency Treated with Recombinant Human Growth Hormone: The Belgian Experience

“…In 34 GHD patients, of whom 6 had isolated GHD and 28 multiple pituitary hormonal deficiencies, treated with 2 or 3 weekly injections of extracted hGH, final height was –1.7 ± 1.3 SDS, being 162.9 ± 7.2 cm in the boys and 149.8 ± 6.7 cm in the girls. Studies on final height in GHD reported in the literature during the last 5 years show mean final height results between –3.0 and –0.7 SDS [6, 7, 8, 9, 20, 21, 22, 23, 24, 25, 26]. In most of these studies patients were treated with different treatment regimens going from low doses of rhGH administered 3 times a week to daily high doses of rhGH adapted as a function of body weight.…”

“…Brämswig et al [6]treated 36 GHD patients, of whom 28 had idiopathic GHD, with subcutaneous rhGH 6–7 times/week in a dose of 13.7 ± 1.1 IU/m 2 /week (equivalent to 0.5 IU/kg/week) and found a mean final height of –1.1 ± 0.9 SDS (compared to Swiss growth references [27]). Blethen et al [7]reported a final height SDS of –0.7 ± 1.4 SDS (compared to American growth references [28]) in 121 GHD patients (102 idiopathic GHD) treated randomly with daily or three times a week rhGH.…”

“…As several studies have shown that daily administration of rhGH resulted in a better growth response [3, 4, 5]and as the supply of rhGH was potentially unlimited, rhGH was administered as daily subcutaneous injections in a dose of 0.5–0.7 IU/kg/week (0.17–0.23 mg/kg/week). So far, only a few studies reported final height data of patients with idiopathic GHD treated only with daily injections of rhGH [6, 7, 8, 9]. In this paper, we report on the growth response to the daily administration of rhGH, we present final height data of 61 Belgian patients with idiopathic GHD and we compared the results obtained in patients with spontaneous puberty with those with induced puberty.…”

Long-Term Results with Growth Hormone Therapy in Idiopathic Hypopituitarism

“…Despite these improvements in therapy, however, published results in terms of AH continue to be unsatisfactory (table 1); in these studies, GHD of different aetiologies (idiopathic and organic) were analyzed together, the age at start of treatment was variable [10], and some patients did not receive daily therapy [10, 11, 12]. These factors might have contributed to the controversial results obtained [10].…”

“…In many studies, however, the age at the start of treatment ranged from 8.4 to 12.9 years [10, 12, 13, 14, 15, 16, 17], suggesting the possibility of a delay in the diagnosis. This delay could also explain, at least in part, the suboptimal therapeutic results (table 3).…”