Growth hormone use in pediatric growth hormone deficiency and other pediatric growth disorders

The diagnosis and management of growth disorders,in children, particularly disorders that respond to therapy with growth hormone (GH), raise challengi ng clinical and economic issues. Several such issues are presented in the f ollowing article in which Dr. Ron Rosenfeld examines the evaluation and dia gnosis of the child with short stature; Dr. David B. Alien discusses the an abolic and metabolic indications for GH treatment in children; Dr. Margaret H. MacGillivray reviews GH dosing, height outcomes, and follow up; and Dr. Craig Alter presents the payer's perspective on the diagnosis and treatmen t of pediatric GH deficiency. In addressing the use of GH in other pediatric populations, Dr. Paul Saenge r focuses on Turner syndrome, Dr. Henry Anhalt on chronic renal insufficien cy of childhood, and Dr. Ray Hintz on idiopathic short stature. Dr. Harvey P. Katz presents one managed care organization's policy and implementation plan that is used to guide decisions regarding coverage for GH treatment.