[Current status of diagnosis and treatment of growth retardation]

During the past 20 years, growth hormone (GH) preparation has been applied for the treatment of short children with growth hormone deficiency (GHD) and its growth promoting effect has been well documented. GH with normal response to pharmacological stimulation tests, was found to be a treatable short stature. In these conditions GH therapy is acceptable on a basis of endocrine replacement therapy. Clinical trials of GH therapy revealed beneficial effects on final height in the patients with Turner syndrome, achondroplasia, and renal failure. The trial on constitutional or non-endocrine short stature also showed growth promoting effects, however, it has been questioned that GH therapy for healthy children except short stature is really beneficial for their final height. Another problem is a difficulty of differential diagnosis of constitutional short stature and delayed adolescence. Clinical indication of GH therapy is now growing rapidly. We should have to decide real indication of GH therapy on the basis of both endocrine physiology and clinical philosophy.