Idiopathic short stature: management and growth hormone treatment.
In the management of ISS auxological, biochemical, psychosocial and ethical elements have to be considered. In boys with constitutional delay of growth and puberty androgens are effective in increasing height and sexual characteristics, but adult height is unchanged. GH therapy is efficacious in increasing height velocity and adult height, but the inter-individual variation is considerable. The effect on psychosocial status is uncertain. Factors affecting final height gain include GH dose, height deficit in comparison to midparental height, age and first year height velocity. In case of a low predicted adult height at the onset of puberty, addition of a GnRH analogue can be considered. Although GH therapy appears safe, long-term monitoring is recommended.
Wit
J M
JM
Department of Pediatrics, Leiden University Medical Center, P.O. Box 9600, Leiden, Zuid-Holland, The Netherlands. j.m.wit@lumc.nl
Reiter
E O
EO
Ross
J L
JL
Saenger
P H
PH
Savage
M O
MO
Rogol
A D
AD
Cohen
P
P
D000365:Age Determination by Skeleton; D001823:Body Composition; D001827:Body Height / Q000187:drug effects; D002986:Clinical Trials as Topic / Q000941:ethics / Q000639:trends; D003376:Counseling; D006130:Growth Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D019382:Human Growth Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D011627:Puberty / Q000187:drug effects / Q000502:physiology; D011788:Quality of Life; D016896:Treatment Outcome
D019382:Human Growth Hormone