THE ENDOCRINE CONTROL OF GROWTH FOR PATIENTS WITH MYELOMENINGOCELE

Myelomeningocele (MMC) is a midline central nervous system disorder in which the majority of patients have Chiari II malformations and hydro cephalus. Both children and adults with MMC have extreme short stature , the etiology of which is multifactorial but now includes abnormaliti es of the hypothalamic pituitary axis. Hypothyroidism, sexual precocit y and growth hormone deficiency also are reported in these patients. T reatment with recombinant human growth hormone leads to increased grow th velocity and improved standard deviation score for stature. Hormone replacement therapy for patients with MMC is feasible and indicated t o optimize growth, development, pubertal progression, and metabolite h omeostasis.