Frequency of glutamic acid decarboxylase autoantibodies in Mexican diabetic children.

OBJECTIVE: Use radio binding assay (RBA) to quantify the frequency of autoantibodies to glutamic acid decarboxylase in Mexican children with type 1 diabetes mellitus (DM 1). RESEARCH DESIGN AND METHODS: GAD antibodies were measured in 140 mestizo children with DM 1, 66 female (47.14%) and 74 male (52.8%); age 11.7 +/- 3.55 years, and range 1.10 to 18.5 years. Most patients were treated with intermediate acting insulin, and some with the former combined with regular insulin. Mean disease duration was 3.11 +/- 2.94 years, and range 1 month to 14.5 years. Once the signed written consent was obtained, a 5.0-mL blood sample was drawn, immediately centrifuged, and the serum was kept frozen to -20 degrees C until RBA evaluation was performed with a commercial kit. RESULTS: The anti-GAD was positive in 76 DM 1 patients (54.28%) with values from 1.11 to 156.73 U/mL, and negative in 64 (45.71%). In 19 positive anti-GAD patients, the test was repeated and levels were found between 1.38 and 156.62 U/mL. An initial control group consisting of 25 healthy non-related volunteers matched by sex and age, showed negative anti-GAD for all. CONCLUSIONS: The frequency of anti-GAD in these patients was lower than that of the DM 1 European patients, but similar to that of Asians. This supports the heterogeneity of the etiopathogenic factors of DM 1 in different ethnic groups.

[Final results of the administration of biosynthetic growth hormone. Preliminary report]. / Resultado final de la administración de hormona de crecimiento biosintética. Informe preliminar.

From March, 1987 to November, 1995, we have included 89 growth hormone-deficient children for treatment for their low height with the biosynthetic growth hormone; 23 of them have concluded treatment. Without taking into account the etiological factor of their deficiency, 6 girls and 17 boys during different lapses had modified their initial height and the scores of the standard deviation as groups, range from 113.11 +/- 14.83 cm and -5.12 +/- 1.21 to 139.11 +/- 8.96 cm. and -2.68 +/- 1.17 in the girls, and from 128.46 +/- 12.49 cm and -4.13 +/- 1.35 to 158.61 +/- 6.47 cm and -1.76 +/- 0.9 in the boys, respectively. These results between the initial height and the score of the standard deviation compared with the final height and the standard deviation score, showed a statistically significant difference of p < 0.001 both in girls and boys. Two girls and 3 boys developed hypothyroidism during the treatment, without any other side effect. We concluded that early and prolonged biosynthetic growth hormone administration in growth hormone-deficient children might produce a final adult height similar to the normal population standards.

[Biosynthetic growth hormone in the treatment of low stature in Turner syndrome]. / Hormona de crecimiento biosintética en el tratamiento de la talla baja del síndrome de Turner.

Fifteen patients with Turner's syndrome with ages between 6.8 to 13.2 years were treated with biosynthetic growth hormone due to their low height. Twelve of them had a 45XO karyotype and three were mosaics; none had a Y line. They started with 0.7 IU/kg/week which were increased to 1.0 IU/kg/week if no height gain was observed during three months. The 15 patients have completed one year of treatment, 8 of them for two years. The height velocity increased significantly (p < 0.001) from 0.24 +/- 0.10 cm/month before treatment (mean +/- SD) to 0.48 +/- 0.09 in the first 12 months of treatment (height increased from 119.1 +/- 8.79 to 124.9 +/- 8.70). In the eight cases who have reached 24 months of treatment, the height velocity increased from 0.27 +/- 0.07 cm/month to 0.47 +/- 0.09 and 0.54 +/- 0.10 at 12 and 24 months respectively (p < 0.001 and p < 0.01 versus the pretreatment gain); height increased from 116.8 +/- 7.0 cm to 122.0 +/- 7.45 and 129.0 +/- 7.18. We found no adverse effects in the patients. It is concluded that the biosynthetic growth hormone treatment in Turner's syndrome can improve low height.

[The null effect of Somatrem during typhoid fever]. / Efecto nulo de Somatrem durante fiebre tifoidea.

The simultaneous occurrence of typhoid fever in a child with an idiopathic growth hormone insufficiency treated with Somatrem, produced a lack of response to the recombinant hormone, evidenced by a lack of growth during the acute disease. It is concluded that the administration of Somatrem should be suspended during the simultaneous occurrence of any severe illness.

[Clinical and biochemical evaluation of the administration of growth hormone]. / Evaluación clínica y bioquímica de la administración de hormona de crecimiento.

Ten children with isolated growth hormone deficiency were treated for 1 year with 0.5 UI/kg week with Somatrem (recombinant human growth hormone), given as intramuscular injections three times weekly. Before treatment the children had a chronological age of 7-12.4 years (mean 10.4 years), with a bone age at least 25% below the chronological age. There was no radiological evidence of an intra or suprasellar mass in any child, and no response to provocative growth hormone tests (with exercise or arginine-insulin injection). Informed written consent for treatment was obtained from the parents of each child. Clinical signs were registered every month; triiodothyronine, thyroxine, thyrotropine, glucose, urea, creatinine, blood cells count, and hemoglobine, glycosylated hemoglobine, glutamic-piruvic and glutamic-oxalacetic transaminases, alkaline phosphatase, anti-human growth hormone and, E. coli antibodies, insulin like growth factor 1, and bone age were assessed every 3 months. The mean height velocity was 0.27 +/- 0.1 cm/month before treatment, and increased throughout treatment to a value of 0.62 +/- 0.16 cm/month after 12 months. Within the first year eight of the 10 children had a height increase of 8.4 +/- 0.98 cm. The other two children showed no significant difference; one of them with a very low socioeconomic status, and the other developed typhoid fever. All of the children showed an advance in bone age, but none reached a bone age appropriate for their chronological age; without modifications in the laboratory parameters. Insulin like growth factor 1 increased in 9 children. Pain at the injection site was the only side effect reported.