Abstract
Six prepubertal children with short stature (<3rd percentile) and growth velocity <4cm/y have been observed for 2 years or more. Gastrointestinal, hepatic, renal and thyroid functions and X-ray skeletal examination, were normal. GH secretion was evaluated in all cases by two tests: exercise-propranolol and insulin induced hypoglycemia. In 4 cases the sleep-induced GH release was also studied. Peaks of GH were higher than 10ng/ml. SA was measured by the Van den Brande method. Normal values (U/ml) were 0.8-1.2. SA was low (0.1-0.6) in 5 cases and 1.35 in one. SA evaluation six months later confirmed these results. In the first 5 cases SA increased (0,8-1.1) after GH administration (2mg/d/7d). Of these, 2 have been treated with GH 6mg/w, one for 9 and the other for 24 months. During therapy, growth velocity (cm/y) increased to 6,5 and 7,2 respectively. In conclusion, SA is of value in the selection of patients with short stature and normal GH secretion who may respond to GH therapy. A certain degree of end-organ somatomedin insensitivity is suggested in the child with normal SA.
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