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.
Ferraris
J R
JR
Departamento de Pediatria, Hospital Italiano de Buenos Aires, Argentina.
Pasqualini
T
T
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