Growth hormone therapy in patients with Turner syndrome

This article summarizes the published data on final height after growth-promoting therapy in Turner syndrome. Using growth hormone (GH) doses ranging between 0.5 and 1.2 IU/kg/week, final height after therapy is improved by 1.5-9.3 cm [final height after therapy vs. projected adult height (PAH)] within various studies. There is no obvious GH dose-response relationship, but a better estimated benefit from therapy seems to result in those studies that combined even rather low GH doses with the anabolic steroid oxandrolone. It is not possible to retrospectively define an optimal treatment regime out of the various published data due to different GH doses, age and dosage of estrogen replacement therapy and the variable methods for calculating the benefit from therapy. It seems to be essential to start estrogens at a safe bone age (> 13 years) in very low doses. Higher GH doses (up to 2.0 IU/kg/week) led to a better growth response during the first years of therapy but data on final height are still to be awaited.