SPONTANEOUS GROWTH AND RESPONSE TO GROWTH-HORMONE TREATMENT IN CHILDREN WITH GROWTH-HORMONE DEFICIENCY AND IDIOPATHIC SHORT STATURE

Isolated idiopathic growth hormone deficiency (GHD) and idiopathic sho rt stature (ISS) can be difficult to distinguish, but the therapeutica l consequences are different, In this report the data on final height of untreated and treated children with GHD and ISS are reviewed, Untre ated GH-deficient individuals who underwent spontaneous puberty (22 ma le, 14 female patients) reached a mean final height of 4.7 SD (range 3 .9 to 6.0) below the population's mean, If puberty was induced (19 mal e patients), mean final height SD score (SDS) was -3.1. Traditional re gimens of GH administration (2-4 injections/wk) in 236 children (184 b oys, 52 girls) with GHD and spontaneous puberty resulted in a final he ight SDS of -2.8 (range -1.5 to -4.7). In 190 children in whom puberty was induced (139 boys, 51 girls) mean final height was -1.6 (range - -1.1 to -2.4). The mean gain in final height SDS is therefore estimate d at 1.5-2.0 in average cases, and 3.5 in extreme cases, Preliminary d ata suggest that on present regimens mean final height may approach ta rget height. In untreated boys with ISS the mean final height was 2-5 cm lower than that predicted before puberty, whereas in girls it was a lmost equal to the prediction. After GH treatment the mean final heigh t was 0.4-3.0 cm higher than the predicted adult height, which results in an average net gain in final height SDS of approximately 0.5-0.8 ( 3-5 cm).