Growth hormone therapy and children with idiopathic short stature: a viable option?

Since the production of biosynthetic growth hormone (GH) began in 1985, there has been growing controversy over appropriate usage for short stature alone. Despite clinical trials for nearly 2 decades, knowledge about the efficacy, safety, and long-term results of GH for this population remains limited. So far, studies of children without growth hormone deficiency (GHD) have found an initial acceleration in growth, but no increase in adult height above pretreatment target height percentiles. Additionally, recent studies have been unable to link normal short stature with adverse psychological effects, while use of GH therapy has been associated with an exacerbation of problems. Thus, there is evidence that GH therapy does not provide the means to overcome either the physical or psychosocial dilemmas of short stature. Health care providers need to recognize the complexity of problems surrounding short stature and look to other "solutions."