• Title/Summary/Keyword: GH insensitivity

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Growth Hormone Treatment in Children with Chronic Kidney Disease (만성 소아 신질환 환자에서의 성장호르몬 치료 인제의대 부산백병원 소아청소년과)

  • Chung, Woo-Yeong
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.14-20
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    • 2009
  • Growth retardation is a common consequenc of chronic kidney disease (CKD) in childhood. Many recent clinical and experimental data indicate that growth failure in CKD is mainly due to a relative GH insensitivity and functional IGF-I deficiency. Glucocorticoids also glucocorticoids interfere with the integrity of the somatotropic hormone axis at various levels. Over the past 10 years, recombinant growth hormone (rhGH) has been used to help short children with chronic kidney disease. A GH dosage of 0.35 mg/kg/week (28 IU/$m^2$/week) appears efficient and safe. Some clinical trial data show that final height will be within the normal target height range when GH treatment is continued for many years without remarkable adverse events.

Growth responses to growth hormone therapy in children with attenuated growth who showed normal growth hormone response to stimulation tests (성장호르몬 자극검사가 정상인 성장 장애 소아 환자에게서 성장호르몬 투여에 따른 성장속도의 변화)

  • Kim, Jae-Hyun;Chung, Hye-Rim;Lee, Young-Ah;Lee, Sun-Hee;Kim, Ji-Hyun;Shin, Choong-Ho;Yang, Sei-Won
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.922-929
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    • 2009
  • Purpose : The aim was to investigate the clinical characteristics and responses to growth hormone (GH) therapy in children with attenuated growth who showed normal GH responses to GH stimulation tests (GHST). Methods : The study included 39 patients with height velocity (HV) of less than 4 cm/yr and normal GHST results. Clinical characteristics of patients were analyzed retrospectively. Results : Eleven were born as small for gestational age (SGA) and 28 as appropriate for age (AGA). In the SGA group, the standard deviation score (SDS) of age and height measured at their first visit was significantly low. Sixteen patients were treated with GH and six of 23 without GH therapy were followed for 1 year after GHST. The mean (range) of HV was 7.7 (4.9 to 11.1) cm/yr in patients with GH therapy and 3.7 (2.7 to 4.5) cm/yr in those without GH therapy, which was statistically significant (P<0.001). In the GH-treated group, HV and difference in height SDS during the treatment increased significantly (P<0.001; P< 0.001, respectively). HV increased after 1 year of GH therapy in the SGA and AGA groups (SGA, P=0.043; AGA, P=0.003). The level of Insulin-like growth factor-I was significantly lower in GH-treated patients with height SDS <-3 than those with ${\geq}3$ (P=0.023). Conclusion : In children with growth failure and normal GHST, HV increases significantly by short-term GH therapy. The assessment of long-term effects of GH therapy is necessary. Moreover, further studies should be considered to evaluate the GH-IGF-I axis due to the possibility of GH insensitivity syndrome.

Clinical and Laboratory Features to Consider Genetic Evaluation among Children and Adolescents with Short Stature

  • Seokjin Kang
    • Journal of Interdisciplinary Genomics
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    • v.5 no.2
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    • pp.18-23
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    • 2023
  • Conventional evaluation method for identifying the organic cause of short stature has a low detection rate. If an infant who is small for gestational age manifests postnatal growth deterioration, triangular face, relative macrocephaly, and protruding forehead, a genetic testing of IGF2, H19, GRB10, MEST, CDKN1, CUL7, OBSL1, and CCDC9 should be considered to determine the presence of Silver-Russell syndrome and 3-M syndrome. If a short patient with prenatal growth failure also exhibits postnatal growth failure, microcephaly, low IGF-1 levels, sensorineural deafness, or impaired intellectual development, genetic testing of IGF1 and IGFALS should be conducted. Furthermore, genetic testing of GH1, GHRHR, HESX1, SOX3, PROP1, POU1F1, and LHX3 should be considered if patients with isolated growth hormone deficiency have short stature below -3 standard deviation score, barely detectable serum growth hormone concentration, and other deficiencies of anterior pituitary hormone. In short patients with height SDS <-3 and high growth hormone levels, genetic testing should be considered to identify GHR mutations. Lastly, when severe short patients (height z score <-3) exhibit high levels of prolactin and recurrent pulmonary infection, genetic testing should be conducted to identify STAT5B mutations.

ORAL AND MAXILLOFACIAL MANIFESTATIONS OF LARON SYNDROME (라론 증후군의 구강 악안면 증상)

  • Shin, Cha-Uk;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Lee, Sang-Hoon;Hahn, Se-Hyun;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.1
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    • pp.139-144
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    • 2009
  • Laron syndrome was first described by Dr. Laron. Administration of exogenous growth hormone failed to stimulate insulin-like growth factor-I(IGF-I) production which was related to postnatal growth, because these patients lacked receptors in the liver for this hormone. The diagnosis of this syndrome is based on the typical features of GH resistance such as normal or elevated serum GH, low serum IGF-I, and impaired IGF-I response to hGH. Laron syndrome patients showed characteristically severe postnatal growth failure and markedly reduced adult height. This report describes the oral and maxillofacial manifestations of children associated with Laron syndrome. Children with Laron syndrome have several dental and skeletal irregularities. Relatively little is known of the direct effect of Laron syndrome on dental development. Further research should be needed.

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