Long-term response to human growth hormone in 36 children with idiopathic growth hormone deficiency

Area of Science:

• Pediatrics
• Endocrinology
• Growth Disorders

Background:

• Idiopathic growth hormone deficiency (IGHD) and multiple pituitary hormone deficiencies (MPHD) affect children's growth.
• Birth trauma, particularly assisted breech delivery, is a significant etiological factor in growth hormone deficiency.
• Previous studies highlight the importance of hormone replacement therapy in managing these conditions.

Purpose of the Study:

• To evaluate the efficacy of long-term human growth hormone (hGH) treatment in patients with idiopathic growth hormone deficiency.
• To assess the impact of dosage and co-administered thyroid hormone on growth outcomes.
• To analyze growth parameters including height velocity, total height gain, and predicted adult height.

Main Methods:

• Long-term treatment with human growth hormone (Crescormon, 12.4 IU/m2/week) administered to 36 patients.
• Classification of patients into IGHD (n=12) and MPHD (n=24) groups, with 19 MPHD patients receiving additional thyroid hormones.
• Growth assessment using height velocity, total height gain, and TW2 (age-based) height prediction.

Main Results:

• The established hGH dose was insufficient to maintain high growth rates beyond the first year of treatment, after initial catch-up growth subsided.
• Patients receiving thyroid hormone supplementation demonstrated improved growth without accelerated bone-age advancement.
• Height prediction analysis indicated variable responses to the treatment regimen.

Conclusions:

• The prescribed human growth hormone dosage may be suboptimal for sustained growth in idiopathic growth hormone deficiency patients.
• Thyroid hormone supplementation appears beneficial for growth, warranting careful evaluation for hypothyroidism and consideration of thyroxine use.
• Individualized treatment adjustments and further research into optimal dosing strategies are recommended.