ABSTRACT
Growth impairment in cystic fibrosis (CF) is worsened by liver disease. Children with CF have serum levels of insulin-like growth factor-I (IGF-I) that are lower than expected for their normal growth hormone (GH) production. In children with CF-related liver disease (CFLD), response to endogenous GH is further reduced. We present our experience with two young children with CFLD given recombinant human GH (rhGH). The first patient was a 5 year-old female with CFLD and poor growth who responded well for 1 1/2 years to rhGH therapy during her initial course and without a significant increase in serum IGF-I, but with a substantial increase in IGF-I concentration when the GH dose was increased. The second patient was a 5 month-old male with advanced liver disease who had transient improved growth and liver function following rhGH. These patients suggest that rhGH is safe and may be effective in children with CFLD.
Subject(s)
Child Development/drug effects , Cystic Fibrosis/complications , Growth Disorders/drug therapy , Human Growth Hormone/therapeutic use , Liver Diseases/complications , Child, Preschool , Cystic Fibrosis/drug therapy , Female , Follow-Up Studies , Growth Disorders/etiology , Human Growth Hormone/pharmacology , Humans , Infant , Liver Diseases/drug therapy , Male , Treatment OutcomeABSTRACT
Polysomnography (PSG) is a useful tool for the diagnosis of sleep disorders in children. This multichannel study obtains information about sleep architecture, respiratory effort, movements during sleep, respiratory events, and gas exchange to facilitate the evaluation of children who have disrupted sleep or suspected SDB. Children should be studied in a sleep laboratory equipped for and staffed with personnel comfortable with and experienced in the performance of PSG in children. The scoring and interpretation of PSG differs in children and adults. The pediatric PSG should be interpreted by a pediatric professional knowledgeable in normal development and sleep disorders in children.
