Introduction: The spectrum of GH deficiency (GHD) in children ranges from complete deficiency, with severe growth retardation, to partial deficiency, with slightly short stature. The administration of GH to children with GHD improves linear growth, mainly during the first 2 years of treatment.
Patients and methods: The study analyzes pattern of growth in 35 children (24 boys, 11 girls) with GHD, in the first year of treatment with hGH. There were three groups, according to pubertal stage (Tanner): ≤8 years (prepubertal) one girls (G) and one boy (B), 812 years (PIIBII G, PIIGII B) 2G, 2B and ≥12 years (minimum PIIIBIII G, PIIIGIII B) 3G, 3B.
Results: Before treatment, SDS for height was −2.5. All had GHD biological confirmed and delayed bone age. The analysis showed: 1B-average growth rate 0.89 cm/month in the first 6 months, similar in the next 6 (0.83 cm/month), mean height gain 9.72 cm±2.6 and bone age (BA) improved with 13.1 months; 1G-average rate higher in the first 6 months (1.02 cm/month), compared to the next 6 (0.67 cm/month), mean gain 10.2 cm±2.3 BA improved with 18.5 months; 2B-average rate 0.63 cm/month in the first 6 months, similar in the next 6 (0.61 cm/month), mean gain 7.33 cm±0.77 BA improved with 17.5 months; 2G-average rate 0.63 cm/month in the first 6 months, 0.78 cm/month in the next 6, mean gain 8.55 cm±1.63 BA improved with 9 months; 3B-average rate 0.72 cm/month in the first 6 months, 0.63 cm/month in the next 6, mean gain 7.94 cm±0.83 BA improved with 15.4 months; 3G-one patient with growth rate 0.6 cm/month in the first 6 months, similar in the next 6, height gain 7.3 cm BA improved with 24 months.
Discussions: We noticed a negative correlation between growth rate and age of beginning treatment. Despite hGH dose adjustment, the growth rate remains lower in children diagnosed later, confirming the importance of an early diagnosis and treatment, prepubertal.