Growth Response to Growth Hormone (GH) Therapy in Children with and without GH Deficiency

Abstract

The diagnosis of growth hormone deficiency (GHD) needs consideration of both clinical and biological aspects such as auxological data, GH provocative tests and active metabolites of GH including IGF-I and IGFBP-3. In children with GHD, recombinant human GH (rhGH) replacement therapy has been used worldwide with minimal serious side effects. This study aimed to report the results of an investigations for GHD, to describe the growth responses to rhGH in deficient children compared to those without GH deficiency, to evaluate the relationship between clinical and biochemical responses, and to describe the experience of diagnosis and treatment with rhGH at Hamad General Hospital, the main hospital in Qatar where most short children are referred for further investigation. The clinical records of 116 short children were reviewed retrospectively. Forty-six failed the clonidine test and 42 of these also failed the glucagon test and were confirmed with GHD. These and 16 children without GDH were treated with rhGH (25 gg/kg/ day) and were evaluated in terms of growth response, HtSDS, changes of IGF-I concentration and the relationship between these parameters. Treatment with GH of short children with GHD does produce a satisfactory growth response but the HtSDS gain was significantly higher in those with GHD compared to children without GHD. Measurement of IGF-I was found not to be a useful diagnostic test in GHD.