The effect of growth hormone supplementation on late nutritional independence in pediatric patients with short bowel syndrome.
OBJECTIVE
The use of growth hormone (GH) supplementation for intestinal adaptation among adult patients with short bowel syndrome (SBS) has provided mixed results. This report examines the effect of GH supplementation on SBS in pediatric patients.


METHODS
Two girls with SBS from neonatal gastrointestinal catastrophes received exogenous GH at 0.3 mg/kg per week subcutaneously and concurrent glutamine supplementation, beginning at 6 and 6(1/2) years of age. Changes in growth (height and weight) and changes in enteral and parenteral energy requirements were evaluated.


RESULTS
Treatment duration was 8 and 2.5 years, respectively. Patient weights increased from the 5th to the 41st percentile and from the 17th to the 23rd percentile, respectively. Height increased from the 1st to the 57th percentile in the former patient and increased from less than the 1st to the 17th percentile in the latter. Both patients are independent of parenteral nutrition and take enteral nutrition alone. Tolerance for enteral diets was significantly improved in each girl, with only 2 stools per day maintained in one patient.


CONCLUSIONS
The data show that late exogenous treatment with GH and glutamine supplementation improved growth parameters in pediatric patients with SBS. Growth hormone and glutamine supplementation may be beneficial in promoting late intestinal adaptation in pediatric patients with SBS. These data also suggest that these adjuncts may be useful in the early phases of intestinal adaptation.
Ladd
Alan P
AP
Section of Pediatric Surgery, Department of Surgery, Indiana University School of Medicine and Riley Children's Hospital, Indianapolis, IN 46202, USA. aladd@iupui.edu
Grosfeld
Jay L
JL
Pescovitz
Ora H
OH
Johnson
Nancy B
NB
D000222:Adaptation, Physiological; D002648:Child; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology; D019587:Dietary Supplements; D004750:Enteral Nutrition; D005260:Female; D005973:Glutamine / Q000627:therapeutic use*; D006128:Growth / Q000187:drug effects*; D013006:Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007279:Injections, Subcutaneous; D007408:Intestinal Absorption / Q000187:drug effects* / Q000502:physiology; D010288:Parenteral Nutrition; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D015430:Weight Gain
D011994:Recombinant Proteins; D005973:Glutamine; D013006:Growth Hormone