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Response of Indian Growth Hormone Deficient Children to Growth Hormone Therapy: Association with Pituitary Size

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Abstract

Objective

To ascertain the impact of pituitary size as judged by Magnetic Resonance Imaging (MRI), on response to Growth Hormone (GH) therapy in GH deficient children.

Methods

Thirty nine children (9.1 ± 2.7 y, 22 boys) with non-acquired GH deficiency (21 Isolated GH deficiency and 18 Combined pituitary hormone deficiency) were consecutively recruited and followed up for one year. Clinical, radiological (bone age and MRI) and biochemical parameters were studied.

Results

Children with hypoplastic pituitary (pituitary height < 3 mm) had more severe height deficit (height for age Z-score −6.0 vs. −5.0) and retardation of skeletal maturation (bone age chronological age ratio of 0.59 vs. 0.48) at baseline as compared to children with normal pituitary heights (p < 0.05 for both). After one year of GH therapy, height for age Z scores and percentage change in height for age Z scores were significantly higher in children with hypoplastic pituitaries (13.8 ± 3.6 and 28.7 % vs. 11.2 ± 4.1 and 21.4 %). Significant co-relation was observed between pituitary height and height for age Z-scores at baseline (r = 0.39, p < 0.05). The predicted adult height using Tanner Whitehouse-2 equations improved from 140.8 to 152.3 cm in children with hypoplastic pituitary when compared to an increase from 145.8 to 153.5 cm observed in children with normal pituitary height (p < 0.05).

Conclusions

Indian growth hormone deficient children with hypoplastic pituitary respond better to therapy with GH in short term.

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Acknowledgements

The authors would like to thank the children and their parents who participated in the study.

Contributions

JS is the neuroradiologist involved in the radiological evaluation of the MRI scans. AVK and VVK are the pediatrician and pediatric endocrinologists involved in the management of these children. VR and VE are involved in the collection of data. VE, SAC, HKP and AVK are involved in statistical analysis of the data. All authors contributed to the manuscript and AVK shall act as a guarantor for the study.

Conflict of Interest

None.

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None.

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Authors and Affiliations

  1. Department of Growth and Pediatric Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India

    Vaman V. Khadilkar & Veena H. Ekbote

  2. Department of Pediatric and Adolescent Endocrinology, Mehta Children’s Hospital, Chetpet, Chennai, India

    Hemchand Krishna Prasad

  3. Department of Pediatric Endocrinology, Max Super Speciality Hospital, Delhi, India

    Vaishakhi T. Rustagi

  4. Department of Radiology, Ruby Hall Clinic, Pune, India

    Joshita Singh

  5. Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India

    Shashi A. Chiplonkar

  6. Department of Growth and Pediatric Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32 Sasoon Road, Pune, 411001, India

    Anuradha V. Khadilkar

Authors
  1. Vaman V. Khadilkar
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  2. Hemchand Krishna Prasad
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  3. Veena H. Ekbote
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  4. Vaishakhi T. Rustagi
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  5. Joshita Singh
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  6. Shashi A. Chiplonkar
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  7. Anuradha V. Khadilkar
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Correspondence to Anuradha V. Khadilkar.

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Khadilkar, V.V., Prasad, H.K., Ekbote, V.H. et al. Response of Indian Growth Hormone Deficient Children to Growth Hormone Therapy: Association with Pituitary Size. Indian J Pediatr 82, 404–409 (2015). https://doi.org/10.1007/s12098-014-1412-9

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  • DOI: https://doi.org/10.1007/s12098-014-1412-9

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