Long-term effects of growth hormone (GH) replacement therapy on hematopoiesis in a large cohort of children with GH deficiency.
The aim of our prospective case-control study was to evaluate long-term effects of GH replacement therapy on erythrocytes parameters, leukocytes, and platelets numbers in a large cohort of children with isolated GH deficiency (GHD). Hemoglobin (Hb) concentration, hematocrit (Hct), mean corpuscular volume, mean corpuscular hemoglobin, red cell distribution width, number of erythrocytes, leukocytes, neutrophils, lymphocytes, monocytes and platelets, ferritin, and C-reactive protein were evaluated in 85 children with isolated GHD (10.20 ± 3.50 years) before and annually during the first 5 years of GH replacement therapy and in 85 healthy children age and sex comparable to patients during 5 years of follow-up. Compared with controls, GHD children at study entry showed lower Hb (-1.18 ± 0.87 vs. -0.40 ± 0.90 SDS, p < 0.0001), red cells number (-0.24 ± 0.81 vs. 0.25 ± 1.14 SDS, p < 0.0001), and Hct (-1.18 ± 0.86 vs. -0.68 ± 0.99 SDS, p < 0.0001). Twelve GHD patients (14 %) showed a normocytic anemia. GH therapy was associated with a significant increase in Hb, Hct, and red cells number which became all comparable to controls within the first 2 years of treatment. Moreover, hemoglobin levels normalized in all anemic GHD patients after 5 years of therapy. No difference between patients and controls was found in leukocytes and platelets numbers neither at baseline nor during the study. GHD in childhood is associated with an impairment of erythropoiesis which causes a normocytic anemia in a considerable percentage of patients. GH replacement therapy exerts a beneficial effect leading to a significant increase of erythrocytes parameters and recovery from anemia. Neither GHD nor GH replacement treatment exerts effects on leukocytes or platelets numbers.
Pediatric Endocrinology Unit, Department of Translational Medical Sciences, University of Naples "Federico II", via Sergio Pansini 5, 80131, Naples, Italy.
Andrea
A
Esposito
Pediatric Endocrinology Unit, Department of Translational Medical Sciences, University of Naples "Federico II", via Sergio Pansini 5, 80131, Naples, Italy.
Donatella
D
Capalbo
Pediatric Endocrinology Unit, Department of Translational Medical Sciences, University of Naples "Federico II", via Sergio Pansini 5, 80131, Naples, Italy.
Lucia
L
De Martino
Pediatric Endocrinology Unit, Department of Translational Medical Sciences, University of Naples "Federico II", via Sergio Pansini 5, 80131, Naples, Italy.
Martina
M
Rezzuto
Pediatric Endocrinology Unit, Department of Translational Medical Sciences, University of Naples "Federico II", via Sergio Pansini 5, 80131, Naples, Italy.
Raffaella
R
Di Mase
Pediatric Immunology Unit, Department of Translational Medical Sciences, University of Naples "Federico II", via Sergio Pansini 5, 80131, Naples, Italy.
Claudio
C
Pignata
Pediatric Endocrinology Unit, Department of Translational Medical Sciences, University of Naples "Federico II", via Sergio Pansini 5, 80131, Naples, Italy. salerno@unina.it.
Mariacarolina
M
Salerno
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000188:drug therapy*; D006410:Hematopoiesis / Q000187:drug effects*; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency* / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011446:Prospective Studies
D019382:Human Growth Hormone
Anemia; GH; GH deficiency; Hemochrome; Leukocytes; Platelets