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Growth hormone deficiency in patients with sickle cell disease and growth failure

Gail Nunlee-Bland1, Sohail R Rana, Patricia E Houston-Yu

  • 1Department of Pediatrics, Howard University College of Medicine, Washington, DC 20060, USA. gnunlee-bland@howard.edu

Journal of Pediatric Endocrinology & Metabolism : JPEM
|June 17, 2004
PubMed

Insights

Growth hormone (GH) deficiency may contribute to growth failure in children with sickle cell disease (SCD). Treatment with GH significantly improved height in GH-deficient pediatric patients with SCD.

Area of Science:

  • Pediatric Endocrinology
  • Hematology
  • Growth Disorders

Background:

  • Growth disorders are prevalent in children with sickle cell disease (SCD).
  • The exact causes of growth disturbances in SCD are multifactorial.
  • Abnormalities in the growth hormone (GH)/insulin-like growth factor-I (IGF-I) axis are implicated.

Purpose of the Study:

  • To assess GH levels via provocative testing in children with SCD experiencing growth failure.
  • To evaluate the efficacy of GH treatment in this cohort.

Main Methods:

  • Reviewed growth records of 79 children with sickle cell hemoglobinopathies.
  • Measured GH levels using arginine and L-Dopa stimulation tests in patients with and without growth failure.
  • Longitudinally followed GH-treated, GH-deficient SCD patients for 5 years.

Main Results:

  • 16.5% of patients (13/79) exhibited growth failure (height SDS < -2 or growth velocity SDS < -2).
  • Five of seven participating children with growth failure received GH treatment for over 3 years, showing significant height SDS improvement.
  • One patient who declined GH treatment experienced worsening height SDS, while another was lost to follow-up.

Conclusions:

  • GH deficiency is a potential contributor to growth failure in some children with SCD.
  • GH therapy may be beneficial for improving growth outcomes in GH-deficient pediatric patients with SCD.
Abstract

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