APPARENT GROWTH-HORMONE DEFICIENCY IN CHILDREN WITH CEREBRAL-PALSY

Ten children with cerebral palsy (CP) and growth failure underwent ass essment of the growth hormone (GH) axis, including spontaneous GH secr etion, GH secretion in response to pharmacological stimulation, and ci rculating levels of insulin-like growth factor-1 (IGF-I) and IGF bindi ng protein-3 (IGFBP-3). Six of the children had subnormal GH secretion consistent with GH deficiency. Subnormal growth velocity was the best clinical predictor of GH deficiency. The large percentage of these ch ildren with apparent GH deficiency is surprising. Possible mechanisms include anatomic abnormalities of the hypothalamic-pituitary axis, psy chosocial deprivation, and an interaction between suboptimal nutrition al status and an abnormal central nervous system.