Evaluatıon of the dıagnosıs and assessment of response to treatment ın patıents wıth growth hormone defıcıency

This study was performed for contribution to literature by evaluation of children who were diagnosed as growth hormone deficiency and treated in the Department of Pediatric Endocrinology and Metabolism.One hundred and forty-two children who were treated with growth hormone between June 2006 and November 2010 were evaluated retrospectively. 142 cases at least one year, 73 cases at least two years, 25 cases at least three years, 9 cases at least four years and two cases at least five years were followed. Body height, SDS of height, BMI, age at the beginning of medical therapy, bone age, pituitary MRG, height age, parents? height, midparental height, SDS of midparental height, IGF-1 level, IGFBP-3 level, responses to the growth hormone stimulation tests and gaining height and SDS of height were recorded in certain periods during GH therapy. Dose of rhGH was applied between 0.2-0.25 mg/kg/week in our department.The average age of the patients was 9.97±3.22 year (55.6% male and 44.4% female). SDS of height was found -3.46±1.18 and delta SDS -2.49±1.39, SDS of midparental height 0.96±0.72, bone age 6.69±3.13 year, height age 6.50±2.77 year and BMI 17.05±3.43 kg/m² before treatment. Height gaining was 11.42±2.89 cm/year in the first six months, 8.55±2.48 cm/year in the second six month, 9.92±2.44 cm/year at the end of the first year, 8.41±1.92 cm/year at the end of the second year, 7.74±1.63 cm/year at the end of the third year, 7.00±1.52 cm/year at the end of the fourth year, 6.25±2.47 cm/year at the end of the fifth year of the medical therapy. SDS of height gaining was 0.80±0.45 after the first year of the medical therapy. While height gaining levels after the first year of the medical therapy were not different according to the sex, SGA, status of puberty, severe short stature and levels of delta SDS, the patients with hypothyroidism had better responses to the medical therapy. We found that the patients had better gaining SDS of height if there was severe short stature or delta SDS under ? 2.5 or being treated at prepubertal age.In conclusion, this study showed that growth velocity during the growth hormone therapy was associated with multiple factors.