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Psychosocial growth failure: a positive response to growth hormone and placebo
T J Boulton1, R Smith, T Single
1Department of Paediatrics, John Hunter Hospital, NSW, Australia.
Insights
Recombinant growth hormone therapy significantly improved growth velocity in children with emotional growth failure. This treatment offers a promising therapeutic option for this condition.
Area of Science:
- Pediatrics
- Endocrinology
Background:
- Emotional factors can cause growth failure in children.
- Assessing growth hormone secretion is crucial for diagnosis.
Purpose of the Study:
- To evaluate the efficacy of recombinant human growth hormone (rhGH) in children with emotional deprivation-induced growth failure.
Main Methods:
- A double-blind, crossover study involving seven children.
- rhGH treatment (1.2 U/kg/week) for six months versus placebo.
- Analysis of growth hormone secretion profiles using PULSAR.
Main Results:
- Growth hormone administration significantly increased growth velocity (SD score +4.66) compared to placebo (-0.60).
- Pretreatment growth hormone secretion profiles were analyzed.
- Insulin-like Growth Factor I (IGF-I) levels did not change significantly.
Conclusions:
- Recombinant human growth hormone is an effective treatment for improving growth in children with emotional growth failure.
- The study highlights the potential of rhGH therapy in specific pediatric growth disorders.
Abstract:
Seven children were diagnosed as having an emotional cause for growth failure. Pretreatment growth hormone secretion profiles during sleep were analysed using PULSAR. Mean (+/- SD) growth hormone concentration was 10.9 (4.4) mU/l, mean peak 19.6 (6.7) mU/l and the peak-to-peak interval 147 (108) min. Mean (SEM) IGF-I was 1.08 (0.31). The seven children received a six-month course of recombinant growth hormone in a double-blind, crossover study using a dose of 1.2 U/kg/week (28 U/m2/week). Daily placebo injections were given for the other six-month epoch, with a one month washout period. The mean (SEM) growth velocity SD score after growth hormone administration was +4.66 (1.88) and after placebo -0.60 (0.69), each value being greater than the pretreatment value of -2.32 (0.122) (p less than 0.0001 on analysis of variance). The change in IGF-I during growth hormone treatment was not significant. No significant changes in food energy or protein intake occurred.