Growth Response in Children with Idiopathic Growth Hormone Deficiency and Organic Growth Hormone Deficiency during Growth Hormone Treatment

Kim, Hun Gy; Yoo, Han Wook

Abstract

PURPOSE
This study was undertaken to compare the growth promoting effect between patients with idiopathic growth hormone deficiency(IGHD) and those with organic growth hormone deficiency(OGHD).
METHODS
Seventeen children with GH deficiency were divided into two groups: 7 IGHD and 10 OGHD including craniopharyngioma(5), sella germinoma(1), prolactinoma(1), Langerhans cell histiocytosis(1) and postirradiation(1). Diagnosis of GHD was made on the basis of two growth hormone provocative tests, serum IGF-1 & IGFBP 3 level, and bone age. Both groups were treated with recombinant human growth hormone(0.6-0.8IU/Kg/week) for 2 years and auxological parameters (height velocity, height SDS CA(standard deviation score for chronologic age)) were analyzed during 2 years of treatment by using KIGS 4.0 software program.
RESULTS
:The mean pretreatment height velocity in both groups did not differ statistically(2.6+/-.8cm/yr in IGHD vs 2.5+/-.9cm/yr in OGHD: p>0.05). However, height velocity after 2 years of growth hormone treatment was significantly greater in IGHD group than in OGHD group(9.0+/-.3cm/yr in IGHD vs 7.2+/-.8cm/yr in OGHD: P<0.05). The height SDS for CA has improved remakably during 2 years of growth hormone treatment; -3.46 SDS before treatment to -1.53 SDS in IGHD group, -2.3 SDS to -0.5 SDS in OGHD group.
CONCLUSION
Growth hormone replacement therapy has remakably improved height velocity and height SDS for CA in both groups during the 2 years of the treatment. However, the height velocity in OGHD group was significantly less than in IGHD, indicating that additional factors such as malnutrition, associated multiple hormone deficiencies, spinal irradiation and sexual precocity might significantly hamper the growth promoting effect in OGHD group during growth hormone treatment.