We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
What should be the diagnosis and management of short children with normal growth hormone secretion and non-primary IGF-I deficiency?
- Authors
Smyczyńska, Joanna; Stawerska, Renata; Lewiński, Andrzej; Hilczer, Maciej
- Abstract
Growth hormone (GH) deficiency (GHD) is currently defined as secondary IGF-I deficiency. In the patients with normal GH secretion, significant increase of IGF-I during generation test excludes primary IGF-I deficiency, however is not an approved indication for GH therapy. The aim of the study was to assess GH therapy effectiveness in children with IGF-I deficiency which turned to be out non-primary, despite normal GH secretion. Patients and methods. Analysis comprised 42 patients with spontaneous (after falling asleep) and stimulated GH peak >10.0 ng/ml, and IGF-ISDS for age and sex <-1.0, in whom IGF-I concentrations increased significantly during generation test, suggesting that IGF-I deficiency is non-primary (npIGFD Group). All patients were subjected to GH therapy. First-year response to treatment: height velocity (HV) increase and IGF-I SDS increase were assessed in all of them, final height (FH) - in 28 patients. The therapy efficacy was compared with 110 children with isolated, partial GHD (pGHD Group), including 42 treated up to FH. Results. In npIGFD Group, height SDS before treatment (H0SDS) was -2.87±0.72, in 1st year of treatment HV increased from 3.8±0.9 to 9.4±1.9 cm/year, IGF-I SDS increased from -2.19±0.78 to 0.34±1.07, FHSDS was -1.14±0.82. In pGHD Group, H0SDS was -2,79±0.59, HV increased from 3.8±1.4 to 9.8±2.1 cm/year, IGF-ISDS increased from -1.76±0.88 to 0.52±0.87, FH SDS was -1.20±0.80. The differences in all the analysed indices of GH therapy effectiveness between the Groups were insignificant. Conclusions. Children with short stature, normal spontaneous and stimulated GH secretion and non-primary IGF-I deficiency may benefit during GH therapy similarly to children with partial GHD. It seems worth considering not diagnose idiopathic short stature in such patients.
- Subjects
PITUITARY dwarfism; SHORT stature; SOMATOTROPIN; HORMONE therapy; SOMATOMEDIN C
- Publication
Pediatric Endocrinology / Endokrynologia Pediatryczna, 2014, Vol 13, Issue 4, p9
- ISSN
1730-0282
- Publication type
Article
- DOI
10.18544/ep-01.13.04.1498