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Growth hormone treatment of Turner syndrome patients with insufficient growth hormone response to pharmacological stimulation tests

  • Endocrinology
  • Original Papers
  • Published:
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Abstract

Growth before and during treatment with biosynthetic human growth hormone (hGH) was studied in 13 patients with Turner syndrome (TS) and a growth hormone (GH) response of less than 10 μg/l to two standard provocative tests. During 1 year of treatment with hGH (0.15 IU/kg per day) height velocity (mean±SD) increased significantly (P<0.001) from 3.7±1.8 cm/year to 7.6±1.5 cm/year. The auxological data in these girls before and during treatment with hGH were similar to those observed in TS patients with a normal response of GH to pharmacological stimuli. It is concluded that in girls with Turner syndrome GH testing should only be performed when height velocity is below the Turner norm. In TS patients with residual growth potential a clinically significant growth acceleration can be obtained with a higher-than-replacement dose of hGH, i.e. 0.15 IU/kg per day, regardless of GH testing.

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Abbreviations

GH:

growth hormone

hGH:

human growth hormone

SDS:

standard deviation score

TS:

Turner syndrome

References

  1. Bottazzo GF, McIntosh C, Stanford W, Preece M (1980) Growth hormone cell antibodies and partial growth hormone deficiency in a girl with Turner's syndrome. Clin Endocrinol 12:1–9

    Google Scholar 

  2. Brook CGD (1978) Growth hormone deficiency in Turner's syndrome. N Engl J Med 298:1203–1204

    Google Scholar 

  3. Butenandt O (1980) Growth hormone deficiency and growth hormone therapy in Ullrich-Turner-syndrome. Klin Wochenschr 58:99–101

    Article  PubMed  Google Scholar 

  4. Duke EMC, Hussein DM, Hamilton H (1981) Turner's syndrome associated with growth hormone deficiency. Scott Med J 26:240–244

    PubMed  Google Scholar 

  5. Frisch H, Häusler G, Blümel P, Schmitt K, Plöchl E (1989) Spontaneous and stimulated growth hormone dynamics, IGF and growth in Turner's syndrome. Acta Endocrinol 120/S1:74–75A

    Google Scholar 

  6. Grüters A, Schnabel K, L'Allemand D, Weber B, Helge H (1989) Diminished growth hormone secretion in patients with Turner's syndrome can be due to their obesity. Acta Endocrinol 120/S1:77A

    Google Scholar 

  7. Kaplan SL, Abrams CAL, Bell JJ, Conte FA, Grumbach MM (1968) Growth and growth hormone: I. Changes in serum level of growth hormone following hypoglycemia in 134 children with growth retardation. Pediatr Res 2:43–63

    PubMed  Google Scholar 

  8. Laczi F, Julesz J, Janaky T, Laszlo FA (1979) Growth hormone reserve capacity in Turner's syndrome. Horm Metab Res 11:664–666

    PubMed  Google Scholar 

  9. Lin TH, Kirkland JL, Kirkland RT (1988) Growth hormone assessment and short-term treatment with growth hormone in Turner syndrome. J Pediatr 112:919–922

    PubMed  Google Scholar 

  10. Marietti G, Caprio L, Solazzi S, Rossodivita A, Artale F, Colabucci F (1981) Sindrome di Turner. Minerva Pediatr 33:374–375

    PubMed  Google Scholar 

  11. Massa G, Vanderschueren-Lodeweyckx M, Malvaux P (1990) Linear growth in patients with Turner syndrome: influence of spontaneous puberty and parental height. Eur J Pediatr 149:246–250

    PubMed  Google Scholar 

  12. Meadow SR, Boucher BJ, Mashiter K, King MNR, Stimmler L (1968) Growth hormone secretion in subjects with ovarian dysgenesis and Turner's syndrome. Arch Dis Child 43:595–597

    PubMed  Google Scholar 

  13. Ranke MK, Blum WF, Haug F, Rosendahl W, Attanasio A, Enders H, Gupta D, Bierich JR (1987) Growth hormone, somatomedin levels and growth regulation in Turner's syndrome. Acta Endocrinol 116:305–313

    PubMed  Google Scholar 

  14. Rappaport R, Sauvion S (1989) Possible mechanisms for the growth retardation in Turner's syndrome. Acta Paediatr Scand [Suppl] 356:82–86

    Google Scholar 

  15. Reiter JC, Craen M, Vliet G van (1988) Growth hormone response to growth hormone releasing factor in Turner syndrome. Pediatr Res 24:530A

    Google Scholar 

  16. Rongen-Westerlaken C, Wit JM, Drop SLS, Otten BJ, Oostdijk W, Delemarre-VanDeWaal HA, Gons MH, Bot A, Van den Brande JL (1988) Methionyl human growth hormone in Turner's syndrome. Arch Dis Child 63:1211–1217

    PubMed  Google Scholar 

  17. Rosenfeld RG, Hintz RL, Johanson AJ, Sherman B, Brasel JA, Burstein S, Chernausek S, Compton P, Frane J, Gotlin RW, Kuntze J, Lippe BM, Mahoney PC, Moore WV, New MI, Saenger P, Sybert V (1988) Three-year results of a randomized prospective trial of methionyl human growth hormone and oxandrolone in Turner syndrome. J Pediatr 113:393–400

    PubMed  Google Scholar 

  18. Ross JL, Long LM, Loriaux DL, Cutler GB (1985) Growth hormone secretory dynamics in Turner syndrome. J Pediatr 106:202–206

    PubMed  Google Scholar 

  19. Rother K, Zachmann M, Kempken B, Grueters A, Schnabel D, L'Allemand D, Häusler G, Frisch H (1989) Effect of recombinant human growth hormone on urinary15N-nitrogen balance in girls with Turner syndrome as compared to children with growth hormone deficiency. Horm Res 32:166–169

    Google Scholar 

  20. Ruvalcaba RHA, Thuline HC, Kelley VC (1972) Plasma growth hormone in patients with chromosomal anomalies. Arch Dis Child 47:307–309

    PubMed  Google Scholar 

  21. Saenger P, Schwartz E, Wiedemann E, Levine LS, Tsai M, New MI (1976) The interaction of growth hormone, somatomedin and oestrogen in patients with Turner's syndrome. Acta Endocrinol 81:9–18

    PubMed  Google Scholar 

  22. Schober E, Frisch H, Waldhauser F, Bieglmayr C (1989) Influence of estrogen administration on growth hormone response to GHRH andl-Dopa in patients with Turner's syndrome. Acta Endocrinol 120:442–446

    PubMed  Google Scholar 

  23. Singer-Granick C, Lee PA, Foley TP, Becker DJ (1986) Growth hormone therapy for patients with Turner's syndrome. Horm Res 24:246–250

    PubMed  Google Scholar 

  24. Takano K, Hizuka N, Shizume K (1986) Treatment of Turner's syndrome with methionyl human growth hormone for six months. Acta Endocrinol 112:130–137

    PubMed  Google Scholar 

  25. Takano K, Shizume K, Hibi I, Committee for the treatment of Turner's syndrome (1989) Turner's syndrome: treatment of 203 patients with recombinant human growth hormone for one year. Acta Endocrinol 120:559–568

    PubMed  Google Scholar 

  26. Tanner JM, Whitehouse RH, Takaishi M (1966) Standards from birth to maturity for height, weight, height velocity and weight velocity: British children 1965. Arch Dis Child 41:454–471

    PubMed  Google Scholar 

  27. Tanner JM, Whitehouse RH, Cameron N, Marshall WA, Healy MJR, Goldstein H (1983) Assessment of skeletal maturity and prediction of adult height (TW2 Method). Academic Press, London

    Google Scholar 

  28. Vanderschueren-Lodeweyckx M, Wolter R, Malvaux P, Eggermont E, Eeckels R (1974) The glucagon stimulation test: effect on plasma growth hormone and on immunoreactive insulin, cortisol and glucose in children. J Pediatr 85:182–187

    PubMed  Google Scholar 

  29. Vanderschueren-Lodeweyckx M, Massa G, Maes M, Craen M, Van Vliet G, Heinrichs C, Malvaux P (1990) Growth promoting effect of growth hormone and low dose ethinyl estradiol in girls with Turner syndrome. J Clin Endocrinol Metab 70:122–126

    PubMed  Google Scholar 

  30. Van Vliet G, Styne DM, Kaplan SL, Grumbach MM (1986) Turner's syndrome and human growth hormone. In: Raiti S (ed) Human growth hormone. Plenum Press, New York, pp 115–121

    Google Scholar 

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Authors and Affiliations

  1. Department of Paediatrics, University of Leuven, Herestraat 49, B-3000, Leuven, Belgium

    G. Massa & M. Vanderschueren-Lodeweyckx

  2. Department of Paediatrics, University of Ghent, Belgium

    M. Craen

  3. Department of Endocrinology, University of Ghent, Belgium

    M. Vandeweghe

  4. Department of Paediatrics, University of Brussels, Belgium

    G. van Vliet

Authors
  1. G. Massa
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  2. M. Vanderschueren-Lodeweyckx
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  3. M. Craen
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  4. M. Vandeweghe
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  5. G. van Vliet
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Massa, G., Vanderschueren-Lodeweyckx, M., Craen, M. et al. Growth hormone treatment of Turner syndrome patients with insufficient growth hormone response to pharmacological stimulation tests. Eur J Pediatr 150, 460–463 (1991). https://doi.org/10.1007/BF01958421

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  • DOI: https://doi.org/10.1007/BF01958421

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