Background: The aim of this study was to determine the beneficial effects of long-term growth hormone (GH) treatment on final height (FH) in 26 children with Russell-Silver syndrome (RSS). Methods: Twenty-six patients (16 males) were diagnosed with RSS at a median age of 2.9 years according to clinical criteria. All patients were prepubertal at the commencement of treatment. They received treatment with biosynthetic human GH for 9.8 years (median) and all attained FH. Results: The median height at the commencement of treatment was –2.7 SDS and increased to –1.3 SDS (p = 0.001). However, FH did not reach target height (–0.90 SDS, p = 0.003). Predictors of FH outcome were: the height at the start of treatment (r2 = 0.419, p < 0.001) (inversely related) and the height gain at onset of puberty (r2 = 0.257, p < 0.001) (positively related). The overall prediction model accounted for 67.6% of height gain. Sitting height improved gradually during GH treatment (–3.3 to –1.0 SDS, p = 0.012), as did weight (–3.3 to –1.3 SDS, p < 0.001) and BMI (–1.5 to –0.2 SDS, p < 0.001). Conclusions: A significant improvement of growth in RSS children has been shown after 10 years of GH treatment with a FH of –1.3 SDS. The shorter the patient at the start of treatment is, the greater the increment in FH. A significant response is also shown at the onset of puberty. GH treatment may also have a beneficial effect on the spinal length of RSS children.

1.
Davies PS, Valley R, Preece MA: Adolescent growth and pubertal progression in the Silver-Russell syndrome. Arch Dis Child 1988;63:130–135.
2.
Tanner JM, Lejarraga H, Cameron N: The natural history of the Silver-Russell syndrome: a longitudinal study of 39 cases. Pediatr Res 1975;9:611–623.
3.
Wollmann HA, Kirchner T, Enders H, Preece MA, Ranke MB: Growth and symptoms in Silver-Russell syndrome: review on the basis of 386 patients. Eur J Pediatr 1995;154:958–968.
4.
Stanhope R, Albanese A, Azcona C: Growth hormone treatment of Russell-Silver syndrome. Horm Res 1998;49(suppl 2):37–40.
5.
Chatelain PG: Auxology and response to growth hormone treatment of patients with intrauterine growth retardation or Silver-Russell syndrome: analysis of data from the Kabi Pharmacia International Growth Study. International Board of the Kabi Pharmacia International Growth Study. Acta Paediatr Suppl 1993;82(suppl 391):79–81.
6.
Ranke MB, Lindberg A: Growth hormone treatment of short children born small for gestational age or with Silver-Russell syndrome: results from KIGS (Kabi International Growth Study), including the first report on final height. Acta Paediatr Suppl 1996;417:18–26.
7.
Rakover Y, Dietsch S, Ambler GR, Chock C, Thomsett M, Cowell CT: Growth hormone therapy in Silver-Russell syndrome: 5 years’ experience of Australian and New Zealand growth database (OZGROW). Eur J Pediatr 1996;155:851–857.
8.
Chernausek SD, Breen TJ, Frank GR: Linear growth in response to growth hormone treatment in children with short stature associated with intrauterine growth retardation: the National Cooperative Growth Study experience. J Pediatr 1996;128:522–527.
9.
Stanhope R, Preece MA, Hamill G: Does growth hormone treatment improve final height attainment of children with intrauterine growth retardation? Arch Dis Child 1991;66:1180–1183.
10.
Price SM, Stanhope R, Garrett C, Preece MA, Trembath RC: The spectrum of Silver-Russell syndrome: a clinical and molecular genetic study and new diagnostic criteria. J Med Gen 1999;36:837–842.
11.
Tanner JM, Whitehouse RH, Takaishi M: Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. I. Arch Dis Child 1966;41:454–471.
12.
Tanner JM, Whitehouse RH, Takaishi M: Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. II. Arch Dis Child 1966;41:613–635.
13.
Marshall WA, Tanner JM: Variations in pattern of pubertal changes in girls. Arch Dis Child 1969;44:291–303.
14.
Marshall WA, Tanner JM: Variations in pattern of pubertal changes in boys. Arch Dis Child 1970;45:13–24.
15.
De Zegher F, Albertsson-Wikland K, Wollmann HA, Chatelain P, Chaussain JL, Löfström A, Jonsson B, Rosenfeld RG: Growth hormone treatment of short children born small for gestational age: growth responses with continuous and discontinuous regimens over 6 years. J Clin Endocrinol Metab 2000;85:2816–2821.
16.
De Zegher F, Hokken-Koelega A: Growth hormone therapy for children born small for gestational age: height gain is less dose dependent over the long term than over the short term. Pediatrics 2005;115:e458–e462.
17.
Ong K, Beardsall K, de Zegher F: Growth hormone therapy in short children born small for gestational age. Early Hum Dev 2005;81:973–980.
18.
De Zegher F, Ong K, van Helvoirt M, Mohn A, Woods K, Dunger D: High-dose growth hormone (GH) treatment in non-GH-deficient children born small for gestational age induces growth responses related to pretreatment GH secretion and associated with a reversible decrease in insulin sensitivity. J Clin Endocrinol Metab 2002;87:148–151.
19.
Eeckels R, Vanderschueren-Lodeweyckx M, Wolter R: Plasma growth hormone determination in Silver-Russell syndrome. Helv Paediatr Acta 1970;25:363–370.
20.
Stanhope R, Ackland F, Hamill G, Clayton J, Jones J, Preece MA: Physiological growth hormone secretion and response to growth hormone treatment in children with short stature and intrauterine growth retardation. Acta Paediatr Scand 1989;349(suppl):47–52.
21.
Boguszewski MCS, Rosberg S, Albertson-Wikland K: Spontaneous 24-hour growth hormone profiles in prepubertal small for gestational age children. J Clin Endocrinol Metab 1995;80:2599–2606.
22.
Rochiccioli P, Tauber M, Moisan V, Pienkowski C: Investigation of growth hormone secretion in patients with intrauterine growth retardation. Acta Paediatr Scand 1989;349(suppl):42–46, 53–54.
23.
Ackland FM, Stanhope R, Eyre C, Hamill G, Jones J, Preece MA: Physiological growth hormone secretion in children with short stature and intrauterine growth retardation Horm Res 1988;30:241–245.
24.
Albanese A, Stanhope R: Persistent short stature in children with intrauterine growth retardation: use of growth hormone treatment. Horm Res 1997;48(suppl 1):63–66.
25.
Azcona C, Albanese A, Bareille P, Stanhope R: Growth hormone treatment in growth hormone-sufficient and -insufficient children with intrauterine growth retardation/Russell-Silver syndrome. Horm Res 1998;50:22–27.
26.
Azcona C, Stanhope R: Absence of catch down growth in Russell-Silver syndrome after short-term GH treatment. Horm Res 1999;51:47–49.
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