We retrospectively investigated growth response to therapy of 12 patients with idiopathic growth hormone deficiency (GHD), who received GH (0.6-0.7 IU/kg/week) in daily subcutaneous injections from before 2 years of age and for a period of 60 months, in order to ascertain whether very early treatment can enable GHD children to catch-up quickly and completely their initial height deficiency. The onset of therapy was followed in all patients during the 1st year by a significant growth spurt, which persisted, even though attenuated, during the following 4 years. Height deficiency for chronological age (CA) significantly and progressively decreased during the entire study period (from -3.7 +/- 1.9 to -1.0 +/- 1.0 SDS, p < 0.0025), with a cumulative height gain of 2.7 +/- 1.6 SDS. In spite of this catch-up growth no patient attained the target percentile by the 5th year of therapy and their average height (CA) was still lower with respect to the average target height (TH) at the last check-up. Because of the significant bone age (BA) delay still persisting in most patients, a further and complete catch-up growth is likely to occur during the next years of treatment, as suggested by the finding that average height (BA) at the last examination was higher than average TH. It is concluded that: a) in spite of modern therapeutical schedules with daily GH injections and frequent adjustments of doses, GHD children, even though treated from before two years of age, fail to catch-up completely their initial height deficiency, at least by the 5th year of therapy; b) a more prolonged treatment is probably needed to allow them to attain their target percentile. This emphasizes the importance of both early diagnosis and long-lasting treatment.
Growth hormone deficient children treated from before two years old fail to catch-up completely within five years of therapy.
GHIZZONI, Lucia;
1998-01-01
Abstract
We retrospectively investigated growth response to therapy of 12 patients with idiopathic growth hormone deficiency (GHD), who received GH (0.6-0.7 IU/kg/week) in daily subcutaneous injections from before 2 years of age and for a period of 60 months, in order to ascertain whether very early treatment can enable GHD children to catch-up quickly and completely their initial height deficiency. The onset of therapy was followed in all patients during the 1st year by a significant growth spurt, which persisted, even though attenuated, during the following 4 years. Height deficiency for chronological age (CA) significantly and progressively decreased during the entire study period (from -3.7 +/- 1.9 to -1.0 +/- 1.0 SDS, p < 0.0025), with a cumulative height gain of 2.7 +/- 1.6 SDS. In spite of this catch-up growth no patient attained the target percentile by the 5th year of therapy and their average height (CA) was still lower with respect to the average target height (TH) at the last check-up. Because of the significant bone age (BA) delay still persisting in most patients, a further and complete catch-up growth is likely to occur during the next years of treatment, as suggested by the finding that average height (BA) at the last examination was higher than average TH. It is concluded that: a) in spite of modern therapeutical schedules with daily GH injections and frequent adjustments of doses, GHD children, even though treated from before two years of age, fail to catch-up completely their initial height deficiency, at least by the 5th year of therapy; b) a more prolonged treatment is probably needed to allow them to attain their target percentile. This emphasizes the importance of both early diagnosis and long-lasting treatment.
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