GH Therapy in Two Patients with Osteochondrodysplasia
Pharmacological therapy for short statured children is feasible only for a very limited number of cases: when the short stature is due to a well-defined cause and when this cause is specifically correctable. Hypopituitarism and coeliac disease are typical examples of this situation; in fact, growth hormone and a gluten-free diet, respectively, may achieve spectacular results. Therefore, no specific therapy is available nowadays for the great majority of patients with growth retardation, including achondroplastic subjects. However, many attempts with aspecific drugs have been performed and some of these are criticizable both theoretically and also ethically. The basis of this therapeutical concept is the hope of finding a substance with no side effects, capable of improving the final adult height (1). In particular, androgens were very commonly employed in treatment (2,3). Today it is known that androgens can certainly increase growth rate, but that they cause at the same time an increase in bone maturation, so that the advantage is rendered null (4). As was mentioned in the beginning, GH therapy should only be used for those subjects who previously showed a specific deficiency; this diagnosis is supported by the association of short stature and a deficient GH response to the provocative tests. Nevertheless, today this is open to discussion, both for the difficulty in defining the normal GH secretion using the response of stimulation tests and for the good therapeutical results obtained in short stature normal variant children (5,6). Patients with osteochondrodysplasia have a normal GH secretion and normal levels of SmC (7,8,9). Following the previous criteria they should not undergo GH therapy. In fact, the achondroplastic children treated with growth hormone showed poor or even negative results (10,11).
KeywordsGrowth Hormone Coeliac Disease Standard Deviation Score Human Growth Hormone Final Adult Height
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