[hrGH treatment of glucocorticoid-induced short stature in children].
The treatment of systemic diseases with glucocorticoids is often associated with decreased height velocity (HV), and can result in shorter final height. Interactions between adrenal and GH-IGF axis have been described and can occur at hypothalamic-pituitary level or at the regulation of IGF system, including the IGF1R signaling. The clinical state of these patients may be considered as an absolute and/or functional IGF-1 deficiency. Interventions aiming to restore the normal function of GH-IGF axis might reduce the glucocorticoids-induced growth suppression in these children. It has been shown that recombinant human GH (hrGH) induces an increase in HV and a decrease in protein loss in patients with juvenile idiopathic arthritis treated with glucocorticoids. Significant increment in HV was also described after hrGH treatment in children under glucocorticoid therapy due to inflammatory bowel disease or renal transplantation. There is a positive correlation between HV and the dose of hrGH. The results support that the IGF-1 deficiency in these children may be counteract by hrGH therapy. The effect of hrGH is observed only during the treatment period and depends on the replacement strategy, nutritional status and disease control.
Martinelli
Carlos Eduardo
CE
Serviço de Endocrinologia Pediátrica, Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil. cemart@fmrp.usp.br
Palhares
Heloísa M Cunha
HM
D001827:Body Height / Q000187:drug effects*; D002648:Child; D005938:Glucocorticoids / Q000009:adverse effects*; D006128:Growth / Q000187:drug effects*; D006130:Growth Disorders / Q000139:chemically induced / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism / Q000502:physiology*
D005938:Glucocorticoids; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I