ESPE Abstracts

Introduction: Children with Growth Hormone deficiency(GHD) should be treated with r-hGH as early as possible after the diagnosis is made. The primary objectives of therapy is to normalize growth during childhood and to achieve final height within their genetic potential.

Objectives: To determine impact of GH treatment on short term linear growth in the 1st year of therapy in children with isolated growth hormone deficiency at Maadi Hospital Pediatric Endocrinology clinic to identify the predictors of growth response.

Patients and methods: This is historical cohort study of 25 short children with GHD.

They were 17 males (68%) and 8 females (32%).

According to Tanner staging, they were classified into 2 groups:

Group 1: 18 pre-pubertal children (72%) and

Group 2: 7 pubertal children (28%).

All children received hGH therapy for a minimum period of 1 year and regularly followed up at 3 months interval.

Inclusion criteria:

A. Proportionate short stature,

B. Age from 2-18 years.

C. Peak stimulated GH less than 10 μg/l by at least one provocative stimulation test (clonidine or insulin),

D. Patients who have already started hGH treatment for at least 6 months before initiation of the study and will complete their treatment in a period not less than 1 year,

E. Height > -2 SDS below the mean height for age and sex.

Exclusion criteria:

A. Chronic illness potentially affecting growth,

B. Genetic syndromes or tumors,

C. Receiving medications affecting growth.

Results: The height velocity in the 1st year of GH treatment ranged from 5.0-9.5 cm with mean ± SD 6.2 ±1.3 cm. Correlation analysis showed that the change in height SDS in the 1st year had a significant positive correlation with basal height SDS (r=0.982, P=0.001) which was evident in both prepubertal and pubertal groups but it was negatively correlated with both chronological age (r=-0.847, P=0.016) and bone age (r=-0.865, P=0.012) in the pubertal group only.

Conclusion: Growth velocity in the 1st year of GH treated children with GHD in the current study was positively correlated with height SDS at start of treatment and was negatively correlated with chronological age and bone age as was shown in the pubertal group so the early administration of GH therapy lead to pronounced acceleration in linear growth during the first year of treatment.