Gonadotrophin releasing hormone agonist treatment with or without recombinant human GH in adopted children with early puberty.
BACKGROUND
Early onset of puberty is frequently observed in adopted children. During treatment with a gonadotrophin releasing hormone agonist (GnRHa), a decrease in height velocity (HV) precludes height gain.


OBJECTIVE
We studied the effect of the addition of GH to GnRHa treatment in a 3-year prospective randomized trial in 30 adopted children with early puberty.


METHODS
Mean age (SD) at start of treatment was 9.6 (0.9) years in girls and predicted adult height (PAH) using a segmented bone age (BA) assessment method was 148.0 (5.3) cm.


RESULTS
HV decreased gradually in both groups with a higher HV in the group with GH addition (group B). No significant difference between the rates of bone maturation [change in bone age (DeltaBA)/change in chronological age (DeltaCA)] of both treatment groups was observed. After 3 years of treatment, PAH increase was 5.7 (3.8) cm in group A (GnRHa alone) and 10.1 (3.8) cm in group B (P < 0.01). IGF-I levels were higher in group B. HV decreased slowly in both groups during treatment, unlike stabilization of IGF-I levels.


CONCLUSIONS
We conclude that, after 3 years of treatment, the addition of GH to GnRHa results in higher HV and a significant increase in PAH compared to GnRHa alone.
Mul
D
D
Erasmus University Medical Centre/Sophia Children's Hospital, Subdivision Endocrinology, 3000 CB Rotterdam, The Netherlands. mul@alkg.azr.nl
Oostdijk
W
W
Waelkens
J J
JJ
Schulpen
T W
TW
Drop
S L
SL
D000300:Adoption; D000886:Anthropometry; D001827:Body Height / Q000187:drug effects; D002648:Child; D004359:Drug Therapy, Combination; D004641:Emigration and Immigration; D005260:Female; D005500:Follow-Up Studies; D006128:Growth / Q000187:drug effects; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008186:Luteolytic Agents / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D011629:Puberty, Precocious / Q000188:drug therapy* / Q000503:physiopathology; D017329:Triptorelin Pamoate / Q000627:therapeutic use*
D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D019382:Human Growth Hormone