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Therapy in Short Children With Subnormal Integrated Concentrations of Growth Hormone

Therapy in Short Children With Subnormal Integrated Concentrations of Growth Hormone Abstract • We evaluated the effect of growth hormone (GH) therapy on the posttreatment growth of 11 poorly growing children who had normal GH response to provocative stimuli but subnormal integrated concentrations of GH. Patients received 0.1 U/kg of GH three times per Week. Their mean (±SD) growth rate increased from 3.3±1.0 cm/y before treatment to 6.5±1.4 cm/y after eight months of treatment. The growth rates of five patients declined to below 4.5 cm/y four months after treatment. Three of these patients resumed GH therapy and again responded with increased growth velocity (8.0±1.2 cm/y). After therapy, the growth rate of five remaining patients continued to be greater than 4.5 cm/y (6.8±1.4 cm/y). Two of these patients had entered puberty and their posttreatment growth rate might have been due to a pubertal growth spurt. The three prepubertal patients in this group had a gradual decline in growth velocity to 3.8±1.0 cm/y by the end of 12 posttreatment months. We conclude that maintenance of normal growth in patients with this pattern of GH deficiency is dependent on GH replacement therapy. (AJDC 1987;141:1195-1198) References 1. Frasier SD: Growth hormone stimulation tests in children , in Raiti S (ed): Advances in Human Growth Hormone Research , publication (NIH) 74-612. US Dept of Health, Education, and Welfare, 1973. 2. Zadik Z, Chalew SA, Raiti S, et al: Do short children secrete insufficient growth hormone? Pediatrics 1985;76:355-360. 3. Kowarski AA: Bioinactive GH and secondary GH deficiency , in Raiti S (ed): Human Growth Hormone . New York, Plenum Press, 1986. 4. Spiliotis BE, August GP, Hung W, et al: Growth hormone neurosecretory dysfunction: A treatable cause of short stature . JAMA 1984;251: 2223-2230.Crossref 5. Bierich JR: Treatment of constitutional delay of growth and adolescence with growth hormone . Klin Padiatr 1983;195:309-316.Crossref 6. Raiti S, Davis WT, Blizzard RM: A comparison of the effects of insulin hypoglycemia and arginine infusion on release of human growth hormone . Lancet 1967;2:1182-1183.Crossref 7. Lanes R, Hurtado E: Oral clonidine: An effective growth hormone–releasing agent in prepubertal subjects . J Pediatr 1982;100:710-714.Crossref 8. Kowarski AA, Thompson RG, Migeon CJ, et al: Determination of integrated concentration of true secretion rate of human growth hormone . J Clin Endocrinol Metab 1971;32:356-360.Crossref 9. Plotnick LP, Thompson RG, Kowarski AA, et al: Circadian variation of integrated concentration of growth hormone in children and adults . J Clin Endocrinol Metab 1975;40:240-247.Crossref 10. Zadik Z, Chalew SA, Meistas M, et al: The influence of age on the 24-hour integrated concentration of growth hormone in normal individuals . J Clin Endocrinol Metab 1985;60:513-516.Crossref 11. Schalch DS, Parker ML: A sensitive double antibody immunoassay for human growth hormone in plasma . Nature 1964;203:1141-1145.Crossref 12. Plotnick LP, Lee PA, Migeon CJ, et al: Comparison of physiological and pharmacological tests of growth hormone in children with short stature . J Clin Endocrinol Metab 1979;48: 811-815.Crossref 13. Ray AA (ed): SAS User's Guide: Statistics . Cary, NC, SAS Institute Inc, 1982. 14. Pertzelan A, Kauli R, Assa S, et al: Intermittent treatment with human growth hormone in isolated growth hormone deficiency and in multiple pituitary hormone deficiencies . Clin Endocrinol 1976;5:15-24.Crossref 15. Raiti S, Trase E, Levitsky L, et al: Oxandrolone and human growth: Comparison of growth-stimulating effects in short children . AJDC 1973;126:597-600. 16. Preece MA, Tanner JM: Results of intermittent treatment of growth hormone deficien[ill] with human growth hormone . J Clin Endocrin[ill] Metab 1977;45:169-170.Crossref 17. Rudman D, Kutner MH, Blackston RD[ill] et al: Children with normal variant short statur[ill] Treatment with human growth hormone for s[ill] months . N Engl J Med 1981;305:123-131.Crossref 18. Hayek A, Peake GT: Growth and somat[ill] medin C responses to growth hormone in dwarfe[ill] children . J Pediatr 1981;99:868-872.Crossref 19. Van Vliet G, Styne DM, Kaplan SL, et a[ill] Growth hormone treatment for short stature N Engl J Med 1983;309:1016-1022.Crossref 20. Gertner JM, Genel M, Gianfredi SP, et a[ill] Prospective clinical trial of human growth ho[ill] mone in short children without growth hormon[ill] deficiency . J Pediatr 1984;104:172.Crossref 21. Rosenfeld RG, Kemp SF, Hintz RL: Con[ill] stancy of somatomedin response to growth hor[ill] mone treatment of hypopituitary dwarfism an[ill] lack of correlation with growth rate . J Clin[ill] Endocrinol Metab 1981;53:611-617.Crossref 22. Plotnick LP, Van Meter QL, Kowarski AA[ill] Human growth hormone treatment of childre[ill] with growth failure and normal growth hormon[ill] levels by immunoassay: Lack of correlation wit[ill] somatomedin generation . Pediatrics 1983;7l[ill] 324-377. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Therapy in Short Children With Subnormal Integrated Concentrations of Growth Hormone

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1987.04460110065023
Publisher site
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Abstract

Abstract • We evaluated the effect of growth hormone (GH) therapy on the posttreatment growth of 11 poorly growing children who had normal GH response to provocative stimuli but subnormal integrated concentrations of GH. Patients received 0.1 U/kg of GH three times per Week. Their mean (±SD) growth rate increased from 3.3±1.0 cm/y before treatment to 6.5±1.4 cm/y after eight months of treatment. The growth rates of five patients declined to below 4.5 cm/y four months after treatment. Three of these patients resumed GH therapy and again responded with increased growth velocity (8.0±1.2 cm/y). After therapy, the growth rate of five remaining patients continued to be greater than 4.5 cm/y (6.8±1.4 cm/y). Two of these patients had entered puberty and their posttreatment growth rate might have been due to a pubertal growth spurt. The three prepubertal patients in this group had a gradual decline in growth velocity to 3.8±1.0 cm/y by the end of 12 posttreatment months. We conclude that maintenance of normal growth in patients with this pattern of GH deficiency is dependent on GH replacement therapy. (AJDC 1987;141:1195-1198) References 1. Frasier SD: Growth hormone stimulation tests in children , in Raiti S (ed): Advances in Human Growth Hormone Research , publication (NIH) 74-612. US Dept of Health, Education, and Welfare, 1973. 2. Zadik Z, Chalew SA, Raiti S, et al: Do short children secrete insufficient growth hormone? Pediatrics 1985;76:355-360. 3. Kowarski AA: Bioinactive GH and secondary GH deficiency , in Raiti S (ed): Human Growth Hormone . New York, Plenum Press, 1986. 4. Spiliotis BE, August GP, Hung W, et al: Growth hormone neurosecretory dysfunction: A treatable cause of short stature . JAMA 1984;251: 2223-2230.Crossref 5. Bierich JR: Treatment of constitutional delay of growth and adolescence with growth hormone . Klin Padiatr 1983;195:309-316.Crossref 6. Raiti S, Davis WT, Blizzard RM: A comparison of the effects of insulin hypoglycemia and arginine infusion on release of human growth hormone . Lancet 1967;2:1182-1183.Crossref 7. Lanes R, Hurtado E: Oral clonidine: An effective growth hormone–releasing agent in prepubertal subjects . J Pediatr 1982;100:710-714.Crossref 8. Kowarski AA, Thompson RG, Migeon CJ, et al: Determination of integrated concentration of true secretion rate of human growth hormone . J Clin Endocrinol Metab 1971;32:356-360.Crossref 9. Plotnick LP, Thompson RG, Kowarski AA, et al: Circadian variation of integrated concentration of growth hormone in children and adults . J Clin Endocrinol Metab 1975;40:240-247.Crossref 10. Zadik Z, Chalew SA, Meistas M, et al: The influence of age on the 24-hour integrated concentration of growth hormone in normal individuals . J Clin Endocrinol Metab 1985;60:513-516.Crossref 11. Schalch DS, Parker ML: A sensitive double antibody immunoassay for human growth hormone in plasma . Nature 1964;203:1141-1145.Crossref 12. Plotnick LP, Lee PA, Migeon CJ, et al: Comparison of physiological and pharmacological tests of growth hormone in children with short stature . J Clin Endocrinol Metab 1979;48: 811-815.Crossref 13. Ray AA (ed): SAS User's Guide: Statistics . Cary, NC, SAS Institute Inc, 1982. 14. Pertzelan A, Kauli R, Assa S, et al: Intermittent treatment with human growth hormone in isolated growth hormone deficiency and in multiple pituitary hormone deficiencies . Clin Endocrinol 1976;5:15-24.Crossref 15. Raiti S, Trase E, Levitsky L, et al: Oxandrolone and human growth: Comparison of growth-stimulating effects in short children . AJDC 1973;126:597-600. 16. Preece MA, Tanner JM: Results of intermittent treatment of growth hormone deficien[ill] with human growth hormone . J Clin Endocrin[ill] Metab 1977;45:169-170.Crossref 17. Rudman D, Kutner MH, Blackston RD[ill] et al: Children with normal variant short statur[ill] Treatment with human growth hormone for s[ill] months . N Engl J Med 1981;305:123-131.Crossref 18. Hayek A, Peake GT: Growth and somat[ill] medin C responses to growth hormone in dwarfe[ill] children . J Pediatr 1981;99:868-872.Crossref 19. Van Vliet G, Styne DM, Kaplan SL, et a[ill] Growth hormone treatment for short stature N Engl J Med 1983;309:1016-1022.Crossref 20. Gertner JM, Genel M, Gianfredi SP, et a[ill] Prospective clinical trial of human growth ho[ill] mone in short children without growth hormon[ill] deficiency . J Pediatr 1984;104:172.Crossref 21. Rosenfeld RG, Kemp SF, Hintz RL: Con[ill] stancy of somatomedin response to growth hor[ill] mone treatment of hypopituitary dwarfism an[ill] lack of correlation with growth rate . J Clin[ill] Endocrinol Metab 1981;53:611-617.Crossref 22. Plotnick LP, Van Meter QL, Kowarski AA[ill] Human growth hormone treatment of childre[ill] with growth failure and normal growth hormon[ill] levels by immunoassay: Lack of correlation wit[ill] somatomedin generation . Pediatrics 1983;7l[ill] 324-377.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Nov 1, 1987

References