Delayed Growth due to Growth Human deficiency, HGH (16 cases study)

Hachicha M, Kammoun T, Kolsi S, Mahfoudh A, Jardak N, Aloulou H, Bouaziz N, Triki A.

CHU Hedi Chaker, Sfax.

Growth hormone deficiency is one of the scarce statural backward causes. It is difficult to make a diagnosis. The purpose of growth hormone treatment is to reach a final normal height and to avoid hypoglycemia after-effects. We give a retrospective account of 16 children (11 boys and 5 girls) who have a growth-delay due to a total growth hormone deficiency confirmed by the stimulation tests and who have also been given benefit of a biosynthetic growth hormone from 1990 to 1999. The statural backwardness varies from--2.5 DS to--4 DS, with an average of--3.5 DS. In all the cases it is a matter of a harmonious backwardness discovered at an average age of 6 years. The bone age has revealed an important backwardness of bone maturation: average bone age of 3 years for boys and 4 years for girls. The hormone balance sheet reveals, in all the cases, a total growth hormone deficiency (GH < 5 ng/ml) combined with a corticotrope deficiency (2 cases) and thyreotrope (3 cases). It is a growth hormone idiopathic deficiency among our patients. The growth hormone treatment has been administered at the average age of 8 years. The weekly doses were (0.4 to 0.8 U/kg). The evolution was favorable with an average growth speed that has gone up from 3 cm/year before the treatment to 10 cm in the first year of the treatment and to 5.5 cm during the second year of the treatment. An average statural gain of 0.8 DS and a bone maturation gain of one year over one year treatment. The authors put into relief the importance of diagnosis criteria of growth backwardness through a GH deficiency and suggest a therapeutic diagram, and a follow-up of the GH biosynthetic treatment.