Abstract
Fifteen per cent of children treated with growth hormone (GH) are receiving treatment for Turner syndrome, but few results are available on final height in the UK. In this study, data were obtained from the UK KIGS database for 485 girls with Turner syndrome who were treated from 1986, allowing an audit of practice and outcome over 10 years. Over the decade, the mean age of starting growth hormone treatment fell from 10.4 to 8.5 years and the starting dose increased from 0.55 to 0.95 IU/kg/week. The frequency of injections increased from three to six or seven/week. Some girls received suboptimal doses, which also differed depending on whether they were based on weight or surface area. To assess what height gain might be expected at final height, all 52 girls who were prepubertal at the start of treatment, which continued for four years or more, and who had reached final height or had a growth velocity < 2 cm/year were selected. Their mean gain in final height was 5.2 cm and the GH dose was 0.78 IU/kg/week over 5.8 years. Final height gain correlated significantly with duration of treatment, total dose received, and first year response, which itself related to starting dose. This audit shows a changing pattern of treatment over the past decade, which in many instances has been inadequate. When treatment starts before puberty and continues through to final height, with a dose of 30 IU/m2/week in six or seven injections, a mean increase in final height of 5 cm or more would be expected.
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- Chu C. E., Paterson W. F., Kelnar C. J., Smail P. J., Greene S. A., Donaldson M. D. Variable effect of growth hormone on growth and final adult height in Scottish patients with Turner's syndrome. Acta Paediatr. 1997 Feb;86(2):160–164. doi: 10.1111/j.1651-2227.1997.tb08858.x. [DOI] [PubMed] [Google Scholar]
- Cole T. J., Hall D. M. Screening for growth: towards 2000. Arch Dis Child. 1996 Feb;74(2):183–183. doi: 10.1136/adc.74.2.183. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Crock P., Werther G. A., Wettenhall H. N. Oxandrolone increases final height in Turner syndrome. J Paediatr Child Health. 1990 Aug;26(4):221–224. doi: 10.1111/j.1440-1754.1990.tb02434.x. [DOI] [PubMed] [Google Scholar]
- Donaldson M. D. Growth hormone therapy in Turner syndrome--current uncertainties and future strategies. Horm Res. 1997;48 (Suppl 5):35–44. doi: 10.1159/000191327. [DOI] [PubMed] [Google Scholar]
- Lyon A. J., Preece M. A., Grant D. B. Growth curve for girls with Turner syndrome. Arch Dis Child. 1985 Oct;60(10):932–935. doi: 10.1136/adc.60.10.932. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nilsson K. O., Albertsson-Wikland K., Alm J., Aronson S., Gustafsson J., Hagenäs L., Häger A., Ivarsson S. A., Karlberg J., Kriström B. Improved final height in girls with Turner's syndrome treated with growth hormone and oxandrolone. J Clin Endocrinol Metab. 1996 Feb;81(2):635–640. doi: 10.1210/jcem.81.2.8636281. [DOI] [PubMed] [Google Scholar]
- Ranke M. B., Guilbaud O., Lindberg A., Cole T. Prediction of the growth response in children with various growth disorders treated with growth hormone: analyses of data from the Kabi Pharmacia International Growth Study. International Board of the Kabi Pharmacia International Growth Study. Acta Paediatr Suppl. 1993 Sep;82 (Suppl 391):82–89. doi: 10.1111/j.1651-2227.1993.tb12936.x. [DOI] [PubMed] [Google Scholar]
- Rosenfeld R. G., Attie K. M., Frane J., Brasel J. A., Burstein S., Cara J. F., Chernausek S., Gotlin R. W., Kuntze J., Lippe B. M. Growth hormone therapy of Turner's syndrome: beneficial effect on adult height. J Pediatr. 1998 Feb;132(2):319–324. doi: 10.1016/s0022-3476(98)70452-4. [DOI] [PubMed] [Google Scholar]
- Van den Broeck J., Massa G. G., Attanasio A., Matranga A., Chaussain J. L., Price D. A., Aarskog D., Wit J. M. Final height after long-term growth hormone treatment in Turner syndrome. European Study Group. J Pediatr. 1995 Nov;127(5):729–735. doi: 10.1016/s0022-3476(95)70161-3. [DOI] [PubMed] [Google Scholar]
- van Teunenbroek A., de Muinck Keizer-Schrama S. M., Stijnen T., Jansen M., Otten B. J., Delemarre-van de Waal H. A., Vulsma T., Wit J. M., Rouwé C. W., Reeser H. M. Yearly stepwise increments of the growth hormone dose results in a better growth response after four years in girls with Turner syndrome. Dutch Working Group on Growth Hormone. J Clin Endocrinol Metab. 1996 Nov;81(11):4013–4021. doi: 10.1210/jcem.81.11.8923853. [DOI] [PubMed] [Google Scholar]