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Idiopathic short stature.
A M Pasquino1, A Albanese, M Bozzola
1Paediatric Endocrinology Service, University La Sapienza Rome, Italy. annamarp@tin.it
Journal of Pediatric Endocrinology & Metabolism : JPEM
|September 1, 2001
Summary
Idiopathic short stature (ISS) in children often involves partial growth hormone (GH) insensitivity. While GH therapy shows no significant height gain or metabolic side effects, long-term psychological benefits remain unproven.
Area of Science:
- Pediatrics
- Endocrinology
- Genetics
Background:
- Idiopathic short stature (ISS) describes children with short stature lacking a specific identifiable cause.
- Many ISS cases involve partial growth hormone (GH) insensitivity, stemming from disruptions in the GH-IGF-I axis.
- Understanding the GH-IGF-I axis is crucial for diagnosing and managing pediatric growth disorders.
Framework:
- Evaluating spontaneous growth in ISS reveals adult height typically aligns with target height.
- Growth hormone (GH) treatment in ISS generally does not yield adult heights significantly exceeding predicted values.
- The GH-IGF-I axis plays a central role in mediating the effects of GH on linear growth.
Implementation:
- Clinical studies assess the efficacy of growth hormone (GH) therapy in children with ISS.
- Investigating potential metabolic side effects of GH therapy, even at higher doses, is important.
- Exploring interventions like puberty manipulation with gonadotrophin-releasing hormone analogues in ISS.
Implications:
- Current evidence suggests limited impact of GH therapy on achieving significantly greater adult height in ISS.
- No significant metabolic side effects have been reported with GH treatment in ISS.
- Long-term psychological benefits of GH therapy for children with ISS are not yet established, warranting further research.