Therapy with a new glucocorticoid: effect of deflazacort on linear growth and growth hormone secretion in renal transplantation.
In children who have undergone successful renal transplantation, the failure of linear growth, a cushingoid appearance and obesity decrease self-esteem and hamper rehabilitation. Changes in kidney function, growth velocity, weight to height ratio and growth hormone (GH) secretion were studied before, and 2 years after, replacement of methylprednisone (6 +/- 0.3 mg/day; mean +/- SEM) by deflazacort (9.6 +/- 0.5 mg/day) 4 years after renal transplantation in 10 patients aged 9-16 years with stable renal function. Serum creatinine and creatinine clearance did not change significantly during deflazacort treatment. In 8 patients at Tanner stage I, growth velocity increased significantly during the 1st and 2nd year of deflazacort therapy (p < 0.01 and p < 0.005, respectively). Weight to height ratio decreased significantly during the 1st and 2nd year of deflazacort treatment (p < 0.005, p < 0.02, respectively) though in 3 patients, this returned to base levels after 2 years of deflazacort therapy. The mean spontaneous GH secretion increased significantly (p < 0.05). There was a correlation between growth velocity and spontaneous GH secretion during deflazacort therapy. The cushingoid appearance decreased in the majority of patients. Renal function remained stable.
Departamento de Pediatria, Hospital Italiano de Buenos Aires, Argentina.
J R
JR
Ferraris
T
T
Pasqualini
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001827:Body Height / Q000187:drug effects*; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D011241:Prednisone / Q000031:analogs & derivatives / Q000627:therapeutic use; D011282:Pregnenediones / Q000627:therapeutic use*; D011863:Radioimmunoassay; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D011282:Pregnenediones; C008352:meprednisone; D013006:Growth Hormone; C021988:deflazacort; D011241:Prednisone