RESEARCH – January 2015

Growth hormone therapy in Children’s Clinic of Tartu University Hospital: a 12-year experience

Authors: Maarja Soomann, Aleksandr Peet, Vallo Tillmann

Articles PDF

Abstract

Background. The commonest indications for growth hormone (GH) therapy in children include growth hormone deficiency (GHD) Turner syndrome (TS) and Prader-Willi syndrome (PWS). GHD is twice as common in boys as in girls. The main aim of GH therapy is to increase final height.

Aims. The aim of this study was to characterise the patients who received GH therapy during a 12-year period at the Children’s Clinic of Tartu University Hospital and to analyse the long-term efficiency of GH treatment.

Methods. Data was collected retrospectively from the medical records of all patients treated with GH between 2002 and 2013 at the Children’s Clinic. Age and gender specific standardised scores (SDS) for height were calculated using the WHO Child Growth Standards.

Results. Altogether 65 children received GH therapy during the study period with the following indications: GHD (n=37; 27 boys), TS (n=18), PWS (n=7, all girls), intrauterine growth retardation (1 girl), chronic renal failure (1 boy) and idiopathic short stature (1girl). The three latter patients received GH for a very short time and were therefore excluded from further analysis. The median age at the beginning of therapy was 9.3 (2.4–15.3) years in the GHD group, 10.5 (7.0–14.7) years in the TS group and 8.1 (1.5–11.2) years in the PWS group. The median height gain SDS in the 32 children who had completed treatment was +2.1 (1.0–3.5) SDS in GHD, +1.6 (0.4–2.0) SDS in TS and +1.3 (0.2–2.1) SDS in PWS.

Conclusions. Having nearly three times more boys in the GHD group suggests a possible underdiagnosis of GHD in Estonian girls whereas PWS seems to be underdiagnosed in boys. Median age at the beginning of treatment and median height gain during the GH therapy were similar to those reported elsewhere. Regular growth monitoring with the use of growth charts is required for timely diagnosis and early treatment. This needs to be improved in Estonia.