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Original Paper

A Comparison of Different Definitions of Growth Response in Short Prepubertal Children Treated with Growth Hormone

Bang P.a · Bjerknes R.b · Dahlgren J.c · Dunkel L.d · Gustafsson J.e · Juul A.f · Kriström B.g · Tapanainen P.h · Åberg V.i

Author affiliations

aDepartment of Women’s and Children’s Health, Karolinska Institute and University Hospital, Stockholm, Sweden; bDepartment of Clinical Medicine, Section for Pediatrics, University of Bergen, Norway; cDepartment of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Sweden; dDepartment of Pediatrics, Kuopio University Hospital, Kuopio, Finland; eDepartment of Women’s and Children’s Health, University of Uppsala, Sweden; fDepartment of Growth and Reproduction, University of Copenhagen, Denmark; gDepartment of Clinical Science, Umeå University, Umeå, Sweden; hDepartment of Pediatrics and Adolescence, University of Oulu, Finland; iInstitut Produits Synthèse (IPSEN) AB, Kista, Sweden

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Horm Res Paediatr 2011;75:335–345

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: June 30, 2010
Accepted: April 11, 2010
Published online: January 12, 2011
Issue release date: May 2011

Number of Print Pages: 11
Number of Figures: 5
Number of Tables: 2

ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)

For additional information: https://www.karger.com/HRP

Abstract

Background: How to define poor growth response in the management of short growth hormone (GH)-treated children is controversial. Aim: Assess various criteria of poor response. Subjects and Methods: Short GH-treated prepubertal children [n = 456; height (Ht) SD score (SDS) ≤–2] with idiopathic GH deficiency (IGHD, n = 173), idiopathic short stature (ISS, n = 37), small for gestational age (SGA, n = 54), organic GHD (OGHD, n = 40), Turner syndrome (TS, n = 43), skeletal dysplasia (n = 15), other diseases (n = 46) or syndromes (n = 48) were evaluated in this retrospective multicenter study. Median age at GH start was 6.3 years and Ht SDS –3.2. Results: Median [25–75 percentile] first-year gain in Ht SDS was 0.65 (0.40–0.90) and height velocity (HtV) 8.67 (7.51–9.90) cm/year. Almost 50% of IGHD children fulfilled at least one criterion for poor responders. In 28% of IGHD children, Ht SDS gain was <0.5 and they had lower increases in median IGF-I SDS than those with Ht SDS >0.5. Only IGHD patients with peak stimulated growth hormone level <3 µg/l responded better than those with ISS. A higher proportion of children with TS, skeletal dysplasia or born SGA had Ht SDS gain <0.5. Conclusion: Many children respond poorly to GH therapy. Recommendations defining a criterion may help in managing short stature patients.

© 2011 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: June 30, 2010
Accepted: April 11, 2010
Published online: January 12, 2011
Issue release date: May 2011

Number of Print Pages: 11
Number of Figures: 5
Number of Tables: 2

ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)

For additional information: https://www.karger.com/HRP


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