GROWTH HORMONE THERAPY;

Classic short stature children

Abstract

Objective: To detect growth hormone deficiency in short stature children and to observe the response of growth hormone
replacement therapy in isolated GH deficient. Design: An interventional descriptive study. Place and Duration of Study: The study was
carried out in the Department of Pediatrics at Military Hospital Rawalpindi in collaboration with Armed Forces Institute of Pathology
Rawalpindi over a period of two years from Jan 2007 to Dec 2008. Patients and Methods: Thirty short children between three to fourteen
years of age having isolated growth hormone deficiency confirmed by laboratory investigation were included in the study prospectively
and retrospectively. Growth hormone replacement therapy with recombinant GH was given to all children at the dose of 0.14iu/kg, six
days a week subcutaneously. Each patient was assessed and evaluated after every three months. Results: The mean chronologic age
was 8.05 +/- 2.74 years with a height age of 4.02 years. The male to female ratio was 1.72:1. They were treated with recombinant GH in a
dose of 0.14iu/kg, six days a week, subcutaneously at evening. Response to GH was excellent and the mean growth speed had gone up
from 2.53 +/- 0.87 cm per year before the treatment to 8.94 +/- 3.18 cm / year in the first twelve months of treatment and 6.8 +/- 1.6
cm / year during the second year of treatment. During the first twenty four months of treatment, height standard deviation score increased
by 1.0 +/- 0.4 SD (p < 0.0001) The height velocity increased, the bone age / chronological age ratio and height SDS for chronological
age decreased, while height SDS for bone age increased. There were no adverse reactions. Conclusion: Short stature with classic growth
hormone deficiency is not uncommon. Early diagnosis and prompt treatment with growth hormone replacement has a very good
outcome and the child attains a reasonable height.