Circulating growth hormone (GH), insulin-like growth factor-I (IGF-I) and free thyroxine, GH response to clonidine provocation and CT scanning of the hypothalamic-pituitary area in children with sickle cell disease.
Serum growth hormone (GH), cortisol, free thyroxine (FT4), thyroid-stimulating hormone (TSH), and insulin like growth factor I (IGF-I) concentrations were measured in 15 children with sickle cell disease (SCD) together with their heights < 5th percentile for age and gender, and in 15 healthy age-matched children who had normal variant short stature (NVSS). GH response to an oral dose of clonidine (0.15 mg/m2) and cortisol response to ACTH stimulation were determined in the two groups. Children with SCD had significantly lower serum concentrations of IGF-I and decreased GH response to stimulation. Eight out of the 15 children with SCD did not mount an appropriate GH response to clonidine provocation (> 10 micrograms/l). CT scanning of the hypothalamic-pituitary area in those eight children with SCD revealed a partial or complete empty sella in all of them. It appears that defective GH release, and consequently low IGF-I production and slow growth velocity in children with SCD might be secondary to hypoxic-vascular insults to their hypothalamic-pituitary axis during one or more of the sickling episodes.
Department of Pediatrics, Royal Hospital, Muscat, Sultanate of Oman.
A T
AT
Soliman
A
A
Darwish
S H
SH
Mohammed
M R
MR
Bassiony
N
N
el Banna
M
M
Asfour
D016022:Case-Control Studies; D002648:Child; D003000:Clonidine; D005260:Female; D006128:Growth; D013006:Growth Hormone / Q000097:blood*; D006450:Hemoglobin SC Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007031:Hypothalamus / Q000000981:diagnostic imaging; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D009850:Oman; D010902:Pituitary Gland / Q000000981:diagnostic imaging; D013974:Thyroxine / Q000097:blood*; D014057:Tomography, X-Ray Computed
D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D003000:Clonidine; D013974:Thyroxine