ESPE Abstracts (2014) 82 P-D-3-2-859

Response of GH Therapy in Six Children with Achondroplasia

Yoon Jung Kima, Byung Wook Choa, Ji Yoon Kima, Heung Sik Kima & Hee Jung Leeb

aDepartment of Pediatrics, Keimyung University School of Medicine, Daegu, Republic of Korea; bDepartment of Radiology, Keimyung University School of Medicine, Daegu, Republic of Korea

Background: Achondroplasia is the most common condition characterized by disproportionate short stature. Patients with achondroplasia progressively fall below normal standards for length and height. GH has been widely used to treat short stature with or without GH deficiency (GHD).

Objective and hypotheses: The purpose of the present study was to clarify the effectiveness of GH therapy on short stature in achondroplasia.

Method: The study included six children (four males and two females, age 2 years–2 months to 7 years–10 months) with achondroplasia. We reviewed height, weight, MRI finding, FGFR3 gene mutation, bone age, IGF1, and growth rate of the patients. GH response to provocation tests with insulin and L-DOPA were evaluated. All six patients were treated with recombinant human GH.

Results: Heights of all patients were under three percentile. Weights were under three percentile in three patients, 3–10 percentile in one patient, 10–25 percentile in one patient, 50–75 percentile in one patient. Brain MRI showed narrowing of foramen magnum in three patients, hydrocephalus in two patients and periventricular leukomalacia in one patient. Four patients underwent decompressive suboccipital craniotomy. FGFR3 mutation showed in five patients and one patient was negative. Bone age was from 1 year–3 months to 7 years–2 months (delayed in four patients). Mean IGF1 level was 50.8 ng/ml and GHD was notified in four patients. The annual height gains after the therapy were 6.8±2.5 cm/year (7.4±0.9 cm/year in patients with GHD and 5.8.±1.5 cm/year in patients without GHD).

Conclusion: Based on our findings, for the management of short stature in children with achondroplasia, response of GH therapy was minimal. Further management for height gain should be considered in achondroplasia patient.

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