GH in RSS kids without GHD

February 21, 2000

Ken M said:

> Hopefully someone will come out with a study showing

> that RSS kids do benefit from growth hormone.

Three articles (journal abstracts from Medline) of that type were in my Feb

21, 2000 post - Digest 308. Those in particular are from Dr. R. Stanhope and

were selected for .

Here is another copy so you don't have to look for them:

The following 3 abstracts were published by Dr. Stanhope during the last 2

years. I believe these could be summarized as - he is a proponent of GHT for

RSS

kids even if they are not GHD. The authors make statements that GHT improves

adult height and

nighttime hypoglycemia with possible improvement in the educational

achievement of such children.

_____________

Title

Growth hormone treatment of -Silver syndrome.

Author

Stanhope R; Albanese A; Azcona C

Address

Department of Endocrinology, Great Ormond Street Hospital for Children,

London, UK.

Source

Horm Res, 1998, 49 Suppl 2:, 37-40

Abstract

-Silver syndrome represents a special group of children with

intrauterine growth retardation (IUGR) who do not experience catch-up growth

and have characteristic dysmorphic features. They also have characteristics

of abnormal growth hormone pulsatility, absence of catch-down growth after

growth hormone therapy and inappropriate advancement of bone age during the

middle childhood years. Data from children with -Silver syndrome

should certainly be analysed as a separate group from short children due to

nondysmorphic IUGR. Initial data suggests that final height outcome will be

improved by using pharmacological doses of biosynthetic human growth hormone.

Indeed, the recent data supports the hypothesis of Blizzard's group in 1974

that if growth hormone became available in sufficient quantities, then final

height could be altered in IUGR children. In addition, the early recognition

and treatment of spontaneous nocturnal hypoglycaemia may well improve the

educational achievement of such children.

------------------------------------------------------------------------------

Title

Absence of catch-down growth in -Silver syndrome after short-term

growth hormone treatment.

Author

Azcona C; Stanhope R

Address

Department of Endocrinology, Great Ormond Street Hospital for Children,

London, UK.c.azcona@...

Source

Horm Res, 1999, 51:1, 47-9

Abstract

We describe 3 children with -Silver syndrome without growth hormone

insufficiency who were treated with growth hormone for 2, 3. 7 and 6 years,

showing a rapid growth acceleration. After cessation of growth hormone

treatment, they grew at a normal rate without 'catch-down' growth. It may be

possible that short intra-uterine growth retardation (IUGR) children with

dysmorphic features respond to growth hormone therapy differently from

non-dysmorphic IUGR short children. Short-term growth hormone treatment for

children with -Silver syndrome may avoid side effects and diminish

costs.

------------------------------------------------------------------------------

Title

Growth hormone treatment in growth hormone-sufficient and -insufficient

children with intrauterine growth retardation/-Silver syndrome.

Author

Azcona C; Albanese A; Bareille P; Stanhope R

Address

Department of Paediatric Endocrinology, Great Ormond Street Hospital for

Children, London, UK.

Source

Horm Res, 1998, 50:1, 22-7

Abstract

Fifty-eight short prepubertal children with IUGR received GH treatment (mean

dose: 28 IU/m2/week) for a mean (SEM) period of time of 3.4 (0.13) years

(range 1-4 years). They were subdivided according to their GH response to a

pharmacological test. Twenty-six were GH insufficient (GHI) (group 1) and 32

were non-GHI (group 2). At the commencement of GH therapy mean chronological

age was 6.1 (0.4) years in both groups, mean height SDS (SEM) was -3.5 (0.2)

in group 1 and -3.6 (0.2) in group 2, mean growth velocity (GV) SDS (SEM) was

-1.9 (0.3) in group 1 and -0.3 (0.2) in group 2. GH therapy induced

significant growth acceleration throughout the follow-up period without any

significant differences between the two groups. GV SDS (SEM) increased to

+3.0 (0.5) in group 1 and to +3.7 (0.4) in group 2 (p < 0.05 compared to

baseline) during the first year of therapy. Subsequently, the

growth-promoting effects of GH therapy diminished with time but GV remained

significantly higher than baseline. This growth enhancement produced a

significant rise in height SDS (SEM) reaching - 1.4 (0.2) in group 1 and -

1.7 (0.2) in group 2 after 4 years. In conclusion, our data did not show any

significant differences in the growth response to GH therapy between

GH-sufficient and -insufficient IUGR children who were only distinguishable

by their GH secretion. This indicates that the decision to treat a short IUGR

child with GH therapy should not be based upon the GH response to a

provocative test.

__________________

Craig

Dad to - RSS, 21 mo, 17 lb ~ 9 oz, 29 1/4 in , Periactin, GH

February 22, 2000

Hi Craig,

Thanks for the abstracts. I have these articles at home. I have also

" spoken " by e-mail with Dr. Stanhope. You are right. He is very much in

favor of GHT for RSS kids. He also says that a definitive study is needed to

show the benefits of growth hormone for RSS. Like he says in his articles,

Rss kids get lumped in with idiopathic short stature and so it is hard to

pinpoint exactly the effect of growth hormone on RSS kids. What is needed is

a " pure " study -- just RSS and not any other disorder.

Again, thanks for the info.

Ken M

GH in RSS kids without GHD

From: CraigBurch@...

Ken M said:

> Hopefully someone will come out with a study showing

> that RSS kids do benefit from growth hormone.

Three articles (journal abstracts from Medline) of that type were in my Feb

21, 2000 post - Digest 308. Those in particular are from Dr. R. Stanhope

and

were selected for .

Here is another copy so you don't have to look for them:

The following 3 abstracts were published by Dr. Stanhope during the last 2

years. I believe these could be summarized as - he is a proponent of GHT

for

RSS

kids even if they are not GHD. The authors make statements that GHT

improves