ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 66 CME3.1 | DOI: 10.1530/endoabs.66.CME3.1

Challenges in the management of the SGA child

Phil Murray


Department of Paediatric Endocrinology, Royal Manchester Children’s Hospital, Manchester, UK


Approximately 650 000 children born in the UK each year, using a definition of a birth weight less than 2 S.D. 14 950 children are born SGA. 90% of these children will experience catch up growth by the age of 4 years leaving around 1500 children eligible for treatment with recombinant human growth hormone. Data from the BSPED audit in 2016 recorded 177 children started on GH at a mean age of 6.2 years – all of these children will have been short at 4 years of age so we are starting GH late in the small minority of SGA children whom we are treating! Frequently SGA children are referred to endocrinologists as possible cases of Silver–Russell Syndrome, the use of clinical scoring systems to identify children with SRS will be discussed as will starting GH from the age of two years in this group. Most endocrinologists currently treat children with GH using dose-titration based upon serum IGF-I concentrations but in SGA children this approach appears to be less effective compared to fixed dosing. The role of GnRH analog therapy or aromatase inhibitors combined with GH will also be discussed. Finally the definition and frequency of poor response to GH treatment will be discussed.

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