GROWTH HORMONE THERAPY;

Abstract

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