Growth hormone treatment for growth failure in pediatric patients with Crohn's disease.
OBJECTIVE
To investigate the effect of human growth hormone (GH) injections on growth velocity in growth-impaired children with Crohn's disease (CD).


METHODS
Ten children and adolescents (mean age, 12.6 +/- 4.5 years; 6 males) with CD and poor height growth were treated with open-label recombinant GH, 0.043 mg/kg/day administered via subcutaneous injection, for 1 year. Patients were retrospectively matched with untreated patients (3 comparisons per case) by race, age, sex, and baseline height. Primary endpoint was height velocity; secondary endpoints were disease activity, body composition, and bone density determined by dual-energy x-ray absorptiometry scan.


RESULTS
Mean height velocity increased by 5.33 +/- 3.40 (mean +/- standard deviation) cm/year in the GH-treated patients during the year of GH treatment, compared with 0.96 +/- 3.52 cm/year in the comparison group (P = .03). Height z-score increased by 0.76 +/- 0.38 in the treated group, compared with 0.16 +/- 0.40 in the comparison group (P < .01), and weight z-score increased by 0.81 +/- 0.89 in the treated group, compared with 0.00 +/- 0.57 in the comparison group (P < .01). Bone density revealed an increase of 0.31 +/- 0.33 in the lumbar spine z-score (P = .03 vs baseline).


CONCLUSIONS
GH treatment increases height velocity and may enhance bone mineralization in children with CD. A randomized controlled trial in a large cohort of children is needed to evaluate the ultimate impact of GH treatment.
Heyman
Melvin B
MB
Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143-0136, USA. mheyman@peds.ucsf.edu
Garnett
Elizabeth A
EA
Wojcicki
Janet
J
Gupta
Neera
N
Davis
Cheryl
C
Cohen
Stanley A
SA
Gold
Benjamin D
BD
Kirschner
Barbara S
BS
Baldassano
Robert N
RN
Ferry
George D
GD
Winter
Harland S
HS
Kaplan
Selna
S
D000293:Adolescent; D000328:Adult; D001823:Body Composition; D001827:Body Height; D015519:Bone Density; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000378:metabolism / Q000628:therapy*; D004703:Endocrine System; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy*; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use
D011994:Recombinant Proteins; D013006:Growth Hormone