SAT-102 Height Improvement with Recombinant Human Growth Hormone Therapy at Terminal Stage of Growth

Abstract

Recombinant growth hormone therapy (rhGH) is known to improve the final adult height in various conditions. The effectiveness of treatment depends on the status of patients, but it is generally known that the younger age the treatment starts, the better effects obtained. The authors experienced that final adult height was dramatically improved with rhGH at the very end stage of deceleration period of growth, so we would like to share our unusual experience. A boy of 13 years and 11 months visited our clinic with cessation of growth. He was 163cm (54%) tall and 62.6kg (78%), and showed Tanner stage IV-V development. There have been no unusual findings in past history and family history. His Mid Parental Height was calculated as 170.5cm (Father: 172cm, Mother: 156cm). After experiencing an acute growth acceleration around 20cm over the past two years, growth rate was abruptly decreased, with 1cm growth in the last nine months. Bone age was 17 years by TW3 method, and pelvic AP x-ray showed Risser stage 4, which is compatible to 17 years in boy. As a result of the above findings, additional height gain was expected to less than 1-2cm and medical intervention for more height gain was expected to impossible. However, the patient and his parents strongly requested rhGH treatment. So, we decided to try rhGH treatment for only three months and then discuss whether or not to extend the treatment after checking up the result. Follow up was conducted every three months, and the height of the patient continued to grow and the closure of the remaining growth plates was confirmed to be delayed. During the one-and-a-half year treatment, no side effects appeared in patient, reaching 173 centimeters, the equivalent of the Korean male standard height. In this case, we experience that the use of Growth hormone can improve the final adult height significantly, even in the end stage of growth, without any other intervention. So, we may consider attempting limitedly to treat growth hormones for height gain, if caregivers or patient strongly request the medical intervention in end stage of the puberty or growth.