One-year treatment with recombinant human growth hormone of children with meningomyelocele and growth hormone deficiency: A comparison of supine length and arm span

Growth retardation and precocious puberty are frequently found in children with meningo-myelocele (MMC), Lower limb contractions, spasticity and kypho scoliosis may lead to disproportionate short stature. Most of these patient s have structural brain defects or hydrocephalus which can cause growth hor mone deficiency. In this study, 19 children aged between 3.5 and 12.8 years with MMC and growth hormone (GH) deficiency were treated with recombinant human GH for a period of 12 months. Supine length, arm span and growth velo city were compared before, and after 6 and 12 months of treatment with rhGH (daily dose 2.0 IU/m(2) BSA s.c.). Mean supine length standard deviation s core (SDS) increased by +0.8 SDS after 6 months and +1.2 SDS after 12 month s of therapy. Mean arm span standard deviation score increased by +0.9 SDS and +1.3 SDS. Growth velocity increased in supine length from 3.3 cm/yr (-2 .1 SDS) to 8.4 cm/yr (+2.4 SDS) and in arm span from 4.8 cm/yr (-1.3 SDS) t o 8.6 cm/yr (+3.1 SDS) in the first 6 months and was 8.1 cm/yr (+2.4 SDS) a nd 8.3 cm/yr (+2.6 SDS) after 12 months of therapy. Linear correlation betw een SDS growth velocity supine length and SDS growth velocity arm span duri ng one year of treatment was excellent (r=0.65, p<0.0025). We surmise that body proportions do not deteriorate when growth velocity is stimulated in MMC patients. Both supine length and arm span measurements a re necessary to document growth in children with spinal dysraphism.