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Treatment of growth failure with human growth hormone in patients with juvenile chronic arthritis. A pilot study
1Department of Rheumatology, University Hospital of Lund, Sweden.
Insights
Human growth hormone (hGH) therapy improved growth rates in children with juvenile chronic arthritis (JCA) and systemic lupus erythematosus (SLE) experiencing growth retardation. The treatment showed no adverse effects, warranting further investigation.
Area of Science:
- Pediatric Endocrinology
- Rheumatology
- Growth Hormone Therapy
Background:
- Growth retardation is a concern in children with juvenile chronic arthritis (JCA) and systemic lupus erythematosus (SLE).
- These conditions often require long-term corticosteroid treatment, which can impede growth.
Purpose of the Study:
- To evaluate the efficacy and safety of human growth hormone (hGH) therapy in children with JCA and SLE suffering from growth retardation.
- To assess the impact of hGH on growth rate and pubertal development.
Main Methods:
- Seven pediatric patients (aged 11.7-17.1 years) with JCA (n=6) or SLE (n=1) and height SDS scores from -2.4 to -6.4 received hGH therapy.
- Treatment duration ranged from six months to three years, with daily hGH doses of 0.07–0.2 IU/kg.
- Patients had a history of corticosteroid use.
Main Results:
- Growth rate significantly increased in most patients within the first year of hGH therapy.
- Mean growth rate rose from 2.8 cm/year pre-treatment to 6.7 cm/year after one year.
- Four patients initiated puberty during the study period.
- No adverse side effects were reported.
Conclusions:
- hGH therapy appears to be an effective and safe treatment for growth retardation in children with JCA and SLE.
- The observed increase in growth rate and progression into puberty suggests positive outcomes.
- Further long-term studies with larger patient cohorts are recommended to confirm efficacy into adulthood.
Abstract:
Six children with JCA and one with SLE, aged 11.7 to 17.1 years, have been treated with human growth hormone (hGH) for six months to three years because of growth retardation. Their height SDS score ranged from -2.4 to -6.4. All have been treated with corticosteroids for 8.4 years on average. The doses of prednisolone were low at the start of the hGH therapy (mean 1.25 mg/day or 2.75 mg/alternate day). Daily doses of hGH ranged from 0.07 to 0.2 IU/kg body weight and day. The growth rate increased during the first year in all but one patient. The mean pretreatment growth rate was 2.8 cm (range 0.3 to 5.7) and had risen to 6.7 cm/year (range 2.8 to 12.4) after one year of treatment. Four patients entered puberty during the first year of treatment. No adverse side effects were observed. Further studies on greater number of patients and follow-up into adult life are needed in order to establish the efficacy of hGH therapy.