Growth hormone treatment in patients with neurosecretory dysfunction.
Twenty-four children (14 boys and 10 girls) with neurosecretory dysfunction, defined by a response greater than 10 ng/ml to two pharmacological tests, and 24-hour GH secretion less than 3 ng/ml/min, were treated with biosynthetic hGH. Mean age was 10 years 8 months +/- 3 years 6 months. Growth retardation was -2.8 +/- 0.8 SD. Eighteen children were prepubertal and six pubertal (P2). Mean peaks in two pharmacological stimulation tests were 25.8 +/- 14.8 and 20.8 +/- 11.5 ng/ml. Somatomedin C/insulin-like growth factor I level was 0.8 +/- 0.6 IU/ml in the prepubertal children. Twenty-four-hour integrated concentration of GH was low, at 2.2 +/- 0.5 ng/ml/min. Analysis of secretory profiles showed 3 types: (1) hyperpulsatile profile with numerous peaks of low amplitude, (2) flat profile, (3) profile with an isolated peak greater than 10 ng/ml. Treatment with hGH (0.42 IU/kg/week) resulted in an increase in growth velocity from 4.9 +/- 1.2 to 6.8 +/- 2.2 cm/year. These results are comparable to those of a group with total GH deficiency receiving the same dose. Analysis of the results showed a group of good responders (n = 14, growth velocity: 8.1 cm/year) and a group of poor responders (n = 10, growth velocity: 4.9 cm/year). Thus, treatment of neurosecretory dysfunction with hGH gives results comparable to those obtained in classic GH secretory dysfunction.
Rochiccioli
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Service de Pédiatrie (Unité d'Endocrinologie), CHU Rangueil, Toulouse, France.
Dechaux
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E
Tauber
M T
MT
Pienkowski
C
C
Tiberge
M
M
D002648:Child; D002675:Child, Preschool; D005260:Female; D006128:Growth / Q000187:drug effects; D013006:Growth Hormone / Q000378:metabolism / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D009489:Neurosecretion / Q000187:drug effects*; D009490:Neurosecretory Systems / Q000187:drug effects; D011863:Radioimmunoassay
D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone