Background: GH (rhGH) treatment improves adult height in GH deficient (GHD) patients. However, there are differences in short and long term responses to treatment between children with permanent deficit (PDGH) and those who present a transient deficit (TDGH) when reassessed at final height (FH).
Objective and hypotheses: To evaluate the response to rhGH treatment in patients with PDGH or TDGH one year after initiating treatment and at FH when treatment was suspended.
Method: Descriptive, retrospective study including 89 patients diagnosed of GHD. Patients were treated with rhGH and followed-up to adult height. TDGH was defined as GH peak greater than 6 ng/ml on final reassessment.
Results: 25/89 patients (28%) had PDGH. Their chronological age at diagnosis was 10.7±2.9 years and height −2.46±0.86 S.D. Age at diagnosis of TDGH group was 10.8±2.7 years and height −2.24±0.68 S.D.. GH peak value was 4.26±2.78 and 6.2±2.01 ng/ml for permanent and transient deficit, respectively. Genetic height and predicted adult height were higher in PDGH. Initial dose of rhGH was 0.030±0.003 mg/kg per day for all patients. When considering on reassessment a height increase >+0.3 S.D., 56% of PDGH and 46% of TDGH had a good response to rhGH. When growth velocity (GV) >+1 S.D. was evaluated, 76% of patients in both groups had a good response. Increase of height and GV were higher in the group of PDGH: +0.55±0.53 and 4.33±3.53 S.D. in this group vs +0.36±0.47 and +2.95±2.54 respectively, in TDGH. FH was −0.81±0.87 S.D. in PDGH patients and −0.95±0.83 S.D. in the TDGH group. Height recovery was greater in patients with DPGH. FH increase over target height was −0.19±1.15 S.D. for PDGH and −0.001±1.09 S.D. for TDGH patients.
Conclusion: PDGH patients had a better response to rhGH than TDGH at 1st year of treatment and at adult height. FH was below their genetic height for all patients.
01 Oct 2015 - 03 Oct 2015