title: [Growth hormone therapy for children with chronic diseases].
abstract: Growth disorders are commonly observed in children suffering from chronic diseases. The pathogenesis of growth failure is multifactorial. In chronic inflammatory diseases such as juvenile idiopathic arthritis and inflammatory bowel disease, growth is also affected by pro-inflammatory cytokines. Patients with chronic diseases might also become growth hormone (GH) deficient. However, normal or increased GH secretion with reduced plasma concentrations of insulin-like growth factor-I indicate a degree of GH insensitivity in some patients. Growth damage can increase with specific treatments, especially if glucocorticoids are used. GH therapy has been used to reduce the consequences of the disease and long-term steroid therapy in these patients. In this review, it is reported the encouraging results of GH treatment in growth-retarded children with chronic diseases, both in well defined indications as well in situations still under investigation.
authors.affiliation: Unidade de Endocrinologia Pediátrica, Departamento de Pediatria, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Alexandre M
authors.initials: AM
authors.lastname: Barreto
authors.forename: Michele C
authors.initials: MC
authors.lastname: Bigolin
authors.forename: Juliana C R Rojas
authors.initials: JC
authors.lastname: Ramos
authors.forename: Lucianna P R R
authors.initials: LP
authors.lastname: Machado
authors.forename: Letícia dos Reis
authors.initials: Ldos R
authors.lastname: Silva
authors.forename: Rodrigo B da
authors.initials: RB
authors.lastname: Silveira
authors.forename: Margaret C S
authors.initials: MC
authors.lastname: Boguszewski
mesh_terms: D001827:Body Height / Q000187:drug effects; D002648:Child; D002908:Chronic Disease; D016207:Cytokines / Q000502:physiology; D004392:Dwarfism / Q000188:drug therapy / Q000209:etiology; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000503:physiopathology
chemical_list: D016207:Cytokines; D019382:Human Growth Hormone