Growth hormone therapy; classic short stature children

ABSTRACT

To detect growth hormone deficiency in short stature children and to observe the response of growth hormone replacement therapy in isolated GH deficient. An interventional descriptive 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. 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. The mean chronologic age was 8.05 +/- 2.74 years with a height age of 4.02 years. The male to female ratio was 1.721. 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. 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