Growth hormone therapy.
Growth hormone (GH) therapy has revolutionized treatment of children with growth hormone deficiency (GHD). Improved height outcome with final height in the target height range has been achieved in these children. Identification of Creutzfeldt-Jakob disease, a deadly prion mediated disorder, in recipients of pituitary GH accelerated the transition from pituitary derived GH to recombinant GH. Once daily subcutaneous administration of the freeze-dried preparation at evening is the recommended mode of GH therapy. Studies have led to use of higher dose of GH for improving height outcome (0.33 mg/kg/week or 0.14 IU/kg/day) albeit at a significantly high cost. Growth velocity increases from 3-4 cm/year before therapy to 10-12 cm/year during the first two years of therapy and is maintained at 7-8 cm/year after a period of two years. Close follow-up with regular clinical and laboratory monitoring is essential for achieving a desirable height outcome. A theoretical unlimited supply has led to wide spread use of GH in a variety of disorders other than GHD. Initially started in children with Turner syndrome, GH has now been used in chronic renal failure, idiopathic short stature and intrauterine growth restriction besides a wide array of newly emerging indications.
Bajpai
Anurag
A
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Menon
P Sn
PS
D000293:Adolescent; D001827:Body Height / Q000187:drug effects*; D002648:Child; D005317:Fetal Growth Retardation / Q000188:drug therapy; D006130:Growth Disorders / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000172:deficiency / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000188:drug therapy; D011218:Prader-Willi Syndrome / Q000188:drug therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D014424:Turner Syndrome / Q000188:drug therapy
D011994:Recombinant Proteins; D019382:Human Growth Hormone