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Growth hormone therapy in a poorly growing child with hypophosphatemic rickets

R Lanes1, H E Harrison

  • 1Department of Pediatrics, Hospital de Clínicas Caracas, Venezuela.

Journal of Endocrinological Investigation
|November 1, 1990
PubMed

Insights

Growth hormone therapy can significantly improve growth rates and predicted adult height in prepubertal males with hypophosphatemic rickets who show poor growth despite standard treatments. This suggests evaluating growth hormone status in such cases.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Bone Disease

Background:

  • Hypophosphatemic rickets (HPR) is a rare genetic disorder characterized by impaired phosphate reabsorption, leading to rickets and poor growth.
  • Standard treatment involves calcitriol and phosphate supplementation, but some patients exhibit suboptimal growth responses.

Observation:

  • A 10-year-old prepubertal male with HPR presented with poor linear growth despite adequate calcitriol and phosphate therapy.
  • Exogenous growth hormone (GH) therapy was initiated, despite normal baseline GH testing.

Findings:

  • GH treatment led to a substantial increase in growth rate, from 3.9 cm/yr to 9 cm/yr in the initial 4 months, and from 2.7 cm/yr to 6.0 cm/yr over the subsequent 14 months.
  • Predicted adult height also improved during the treatment period.
  • Minor metabolic changes observed included increased serum phosphorus and decreased 24-hour urine calcium.

Implications:

  • Evaluating growth hormone status in children with HPR and poor growth is warranted.
  • A trial of growth hormone therapy may be beneficial for select patients with HPR unresponsive to conventional treatment.

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