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      Catch-Up Growth after Childhood-Onset Substitution in Primary Hypothyroidism: Is It a Guide towards Optimal Growth Hormone Treatment in Idiopathic Growth Hormone Deficiency?

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          Abstract

          Catch-up growth was analyzed in 20 prepubertal children with primary hypothyroidism (PH) starting treatment at an age of 4.4 (1.2–10.1) years and a height (HT) SD score (HT SDS) of –3.1 (±0.8). All patients were followed for at least 3 prepubertal years. HT velocity was 12.3 ± 2.3, 9.0 ± 1.8 and 7.5 ± 2.2 cm/year, and change in HT SDS was 1.60 ± 0.56, 0.57 ± 0.33 and 0.28 ± 0.38 during the 1st, 2nd and 3rd year, respectively. The 11 children followed to adult height reached a HT SDS of –0.11 ± 1.1, all within their target HT range. HT gain (ΔHT SDS) during the 1st year was correlated with the degree of catch-up growth (r<sup>2</sup> = 0.78, p < 0.001). While catch-up growth in childhood-onset PH is complete, this is not the case in GH deficiency (GHD). Based on the auxological characteristics of the patients with PH, HT velocities during the first 2 years were predicted applying prediction models devised for prepubertal children with idiopathic GHD. The modalities of GH treatment observed in the models were used to calculate predicted HT velocities of the PH patients. Observed HT velocities in PH were higher than predicted HT velocities during the 1st (10.67 ± 1.37 cm/year, p < 0.01) and 2nd (8.35 ± 0.86 cm/year, p = 0.128) year. The data show that catch-up potential in idiopathic GHD of childhood onset is reduced compared to PH. Since early catch-up as well as total HT recovery in children with GHD are often not reached by present treatment modalities, catch-up growth in PH may serve as a model towards optimizing GH treatment. The data suggest that initial GH doses of 1.0 IU/kg/week, rather than the presently recommended 0.6 IU/kg/week, need to be given in GHD in order to achieve the degree of early catch-up observed in PH and to consequently improve the final outcome.

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          Factors predicting the response to growth hormone (GH) therapy in prepubertal children with GH deficiency

           S L Blethen (1993)
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            Author and article information

            Journal
            HRE
            Horm Res Paediatr
            10.1159/issn.1663-2818
            Hormone Research in Paediatrics
            S. Karger AG
            1663-2818
            1663-2826
            1998
            November 1998
            14 January 1999
            : 50
            : 5
            : 264-270
            Affiliations
            a University Children’s Hospital, Tübingen, b University Children’s Hospital, Magdeburg, c Children’s Hospital, Osnabrück, d University Children’s Hospital, Leipzig, Germany
            Article
            23288 Horm Res 1998;50:264–270
            10.1159/000023288
            9873194
            © 1998 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            Figures: 2, Tables: 1, References: 31, Pages: 7
            Categories
            Original Paper

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