Evaluation of The Response of Children with Short Stature to A Six Months Treatment with Recombinant Human Growth Hormone
Kerbala Journal of Medicine,
Volume 9, Issue 2, Pages 2569-2574
Abstractbackground: Human Growth hormone (GH) is 191amino acids protein , gene located on long arm of chromosome 17. its secretion is under control of 2 hypothalamic hormones: growth hormone releasing hormone(GHRH) and somatostatin. Growth hormone is a major promoter of anabolism, its effects on growth are believed to be indirect ,being mediated through peptides called somatomedins or insulin-like growth factors (IGFs) that in turn mediate many of the growth promoting effects of Growth hormone . Recent advances have focused on biological actions of IGFs & their six well defined binding proteins (IGFBPs), the major one is IGF-BP3 which decreased in GH-deficient children. IGFs are GH-dependent serum peptide with potent metabolic & mitogenic activities believed to be responsible for growth effects of GH, they stimulate cellular replication & differentiation .
Objective: To evaluate the difference in the response of the children with short stature (of different causes) to a six months treatment with recombinant human GH .
Patients And Methods: this is a prospective study in which a total no. of 84 pt (with age ranging from 4-20 years) were included. They were presenting to the endocrine clinic in Al-Mansour teaching hospital for children in 2002 with short stature & growth delay. After the final diagnosis was made, all pt were treated by recombinant GH (in a dose of 0.1-0.2 unit/kg / day) by subcutaneous or intramuscular route at night time (7-8pm) , After completing 6 months of treatment with GH, the patients were evaluated again for height and height velocity, weight, bone age, height age, sexual maturity rate, testicles and phallus in male.
Results: There was no significant difference in response to the therapy between male and female ; the mean height velocity in male was 9.37 +/-3.99 cm / year (ranging from 1-19 cm) and the mean height velocity in female was 9.90 +/-4.39 cm / year ranging from 3-20 cm . Conclusion: Growth hormone therapy is effective in increasing the height velocity in most patients with short stature and it should be initiated as early as possible to improve height as much as possible.
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