[Treatment of hypophyseal nanism]

Early diagnosis of total or partial GH (GHD) deficiency permits immediate treatment with biosynthetic GH and the achievement of a final stature close to the target one. However we frequently observe a progressive reduction in rate of growth ("vaning") during this therapy which delays attainment of adult stature compared to normal subjects. Subacute administration of GH on alternating days results in fair comparability of GH and Sm-C levels with physiological levels and it is therefore preferable to the i.m. route. Treatment should be interrupted when the growth rate is L2 cm/year or upon attainment of puberal stage P4 (female)-P5 (male). Rare side effects are the appearance of hypothyroidism, anti-GH antibodies (treatment with Met-Gh) and Creutzfeldt-Jakob disease (extractive GH).