THERAPY WITH A NEW GLUCOCORTICOID - EFFECT OF DEFLAZACORT ON LINEAR GROWTH AND GROWTH-HORMONE SECRETION IN RENAL-TRANSPLANTATION

In children who have undergone successful renal transplantation, the f ailure of linear growth, a cushingoid appearance and obesity decrease self-esteem and hamper rehabilitation. Changes in kidney function, gro wth velocity, weight to height ratio and growth hormone (GH) secretion were studied before, and 2 years after, replacement of methylpredniso ne (6 +/- 0.3 mg/day; mean +/- SEM) by deflazacort (9.6 +/- 0.5 mg/day ) 4 years after renal transplantation in 10 patients aged 9-16 years w ith stable renal function. Serum creatinine and creatinine clearance d id not change significantly during deflazacort treatment. In 8 patient s at Tanner stage I, growth velocity increased significantly during th e 1st and 2nd year of deflazacort therapy (p < 0.01 and p < 0.005, res pectively). Weight to height ratio decreased significantly during the 1st and 2nd year of deflazacort treatment (p < 0.005, p < 0.02, respec tively) though in 3 patients, this returned to base levels after 2 yea rs of deflazacort therapy. The mean spontaneous GH secretion increased significantly (p < 0.05). There was a correlation between growth velo city and sponanteous GH secretion during deflazacort therapy. The cush ingoid appearance decreased in the majority of patients. Renal functio n remained stable.