Response of Height Measurements to Growth hormone therapy in Short Children with Growth hormone Deficiency


Abstract:Background: longitudinal assessment of growth is essential child care.Objective: to find out the response of growth in term of the number of the standard deviations below the mean of height for age and sex (Z score) (HAZ) to the recombinant human growth hormone therapy in short children with growth hormone deficiency and others.Patients & Methods: A prospective study was done on 325 children; their age range was 1-19years, referred to growth hormone clinic of Central Teaching Hospital for Children / Baghdad with short-stature for their age or with slow growth. The study included only those children on regular recombinant human growth hormone (rhGH) therapy for (6 months - 4 years), for the period between 1st of October 1997 till 1st of March 2003. Evaluation included: detailed medical history, physical examination (included height measurements) and laboratory tests such as blood count, general urine examination, thyroid function, growth hormone assay (basal and after simulation with clonidine 75-100mcg/m2), bone age and chromosomal analysis from peripheral blood, and those who were diagnosed as growth hormone deficiency, were commenced on growth hormone therapy in a dose of (0.24-0.3 mg / kg /wk). Results: has shown a highly significant increase in the Z-score of height for age (HAZ) of children with growth hormone deficiency in response to (rhGH) therapy in a dose (0.24-0.3mg/kg/wk) from (-4.28+1.99) to (-1.86+2.48), while the patients with Turner syndrome from (-4.33+2.02) to (-1.94+2.52), when treated with (rhGH) in a dose (0.3-0.37mg/kg/wk), so as in patients with growth hormone deficiency and celiac disease who were on gluten free diet for one year, but the response was less in children with achondroplasia or with others like Down syndrome and Silver-Russell syndrome. The response was more significant in the prepubertal than pubertal age groups.Conclusion: earlier identification of short children due to growth hormone deficiency & earlier treatment to have a better response & similarly earlier identification of short females with Turner syndrome.Key words: growth hormone deficiency, height measurement, short stature