• Title/Summary/Keyword: Growth hormone therapy

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Improving Adherence to Growth Hormone (GH) Therapy via EasypodTM May Help Maximize the Treatment Outcome

  • Choi, Hae-Jeong
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.1 no.1
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    • pp.19-22
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    • 2015
  • In Growth Hormone (GH) therapy, suboptimal adherence is a common problem, reaching up to 82%, and there is a need for interventions to improve adherence and to maximize patients' growth potential eventually. Current studies have demonstrated the association between the rate of non-adherence and reduced height velocity. In order to maximize patients' potential to grow, an auto-injecting/recording device, such as $easypod^{TM}$, may help improve adherence and optimize the treatment effects of GH therapy. The use of $easypod^{TM}$ has contributed to high adherence rates: 87.5% and 93% in Bozzola et al.'s study and the $Easypod^{TM}$ Connect Observational study (ECOS), respectively. Improvement of adherence by $easypod^{TM}$ may lead to higher growth rates of patients receiving GH therapy. Additionally, patients' positive acceptability of $easypod^{TM}$ suggests $easypod^{TM}$ is a preferred device by patients for better adherence.

Concomitant occurrence of Turner syndrome and growth hormone deficiency

  • Yu, Jung;Shin, Ha Young;Lee, Chong Guk;Kim, Jae Hyun
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.121-124
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    • 2016
  • Turner syndrome (TS) is a genetic disorder in phenotypic females that has characteristic physical features and presents as partial or complete absence of the second sex chromosome. Growth hormone deficiency (GHD) is a condition caused by insufficient release of growth hormone from the pituitary gland. The concomitant occurrence of TS and GHD is rare and has not yet been reported in Korea. Here we report 2 cases of TS and GHD. In case 1, GHD was initially diagnosed. Karyotyping was performed because of the presence of the typical phenotype and poor response to growth hormone therapy, which revealed 45,X/45,X+mar. The patient showed increased growth velocity after the growth hormone dose was increased. In case 2, a growth hormone provocation test and chromosomal analysis were performed simultaneously because of decreased growth velocity and the typical TS phenotype, which showed GHD and a mosaic karyotype of 45,X/46,XX. The patient showed spontaneous pubertal development. In female patients with short stature, it is important to perform a throughout physical examination and test for hormonal and chromosomal abnormalities because diagnostic accuracy is important for treatment and prognosis.

The Effect of Hormone and Pulmonary Function in the Scoliosis Patients after Trunk Stabilization Exercise (체간안정화 운동이 측만증 환자의 폐기능과 호르몬에 미치는 효과)

  • Lee, Woohyung;Lee, Yoonmi
    • Journal of The Korean Society of Integrative Medicine
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    • v.6 no.1
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    • pp.63-74
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    • 2018
  • Purpose: The purpose of this study was to evaluate the effect of a trunk stabilization exercise program on the participants' scoliosis angle, pulmonary function, and growth hormones. Method: In the study, 30 participants were divided into a normal scoliosis exercise group (n=15) and an obese scoliosis exercise group (n=15). The participants performed a trunk stabilization exercise program three times a week for 12 weeks, and the exercise sessions lasted 50 minutes. The participants' pulmonary function [FVC, FEV1, FEV1/FVC, and PEF] was measured using a CardioTouch 3000S, and their scoliosis angles were measured using the Cobb's angle. The levels of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) were analyzed on an immunoradiometric assay (IRMA) and radioimmunoassay (RIA), respectively. Results: After the intervention, the scoliosis angle, hormone levels, and pulmonary function increased significantly in both groups (p<.05). The result of the intergroup difference test indicated statistically significant differences in the three items (scoliosis angle, hormone levels, and pulmonary function) between the two groups (p<.05). Conclusion: Therefore, this program may be recommended as a therapeutic intervention for patients with scoliosis.

Growth promoting effect of combined gonadotropin releasing hormone analogue and growth hormone therapy in early pubertal girls with predicted low adult heights (예측성인신장이 작은 조기사춘기 여아에서 성선자극호르몬 방출호르몬 효능약제와 성장호르몬 병합치료의 성장획득 효과)

  • Hong, Eun-Jeong;Han, Heon-Seok
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.678-685
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    • 2007
  • Purpose : Recent reports pointed out that gonadotropin releasing hormone analogue (GnRHa) therapy alone is not so promising for improving adult height in precocious puberty. So, that we studied the growth promoting effect of combined therapy with GnRHa and growth hormone (GH) in early pubertal girls. Methods : Twenty three early pubertal girls ($9.73{\pm}1.59yr$) with predicted adult heights (PAH) below-2 standard deviation score (SDS) were included. They were divided into two groups as follows; Group I before menarche (n=19) and Group II after menarche (n=4). After combined therapy, various growth parameters were compared between two groups and between the before and after therapy. Results : Between the two groups before therapy, chronologic age (CA), growth velocity (GV), body mass index (BMI), target height (TH), PAH and serum insulin-like growth factor binding protein-3 were not different, but BA, height and difference between bone age (BA) and CA were significantly higher and insulin-like growth factor-1 (IGF-1) was marginally higher in group II. After therapy, BA still remained higher in group II, but other parameters were not different. In both groups, after therapy, the difference between BA and CA, the ratio of BA over CA, and GV were significantly decreased, but PAH, height SDS and BMI were significantly increased. Regarding IGF-1 level, a significant increase was noted in group I, but not in group II. Conclusion : With combined therapy of GnRHa and GH, PAH in early pubertal girls might be improved significantly and even approach TH. Among them, those who were before menarche might have greater potential for the height gain than those after menarche in view of IGF-1 changes during therapy.

Comparison of effectiveness of growth hormone therapy according to disease-causing genes in children with Noonan syndrome

  • Jo, Kyo Jin;Kim, Yoo Mi;Yoon, Ju Young;Lee, Yeoun Joo;Han, Young Mi;Yoo, Han-Wook;Kim, Hyang-Sook;Cheon, Chong Kun
    • Clinical and Experimental Pediatrics
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    • v.62 no.7
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    • pp.274-280
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    • 2019
  • Purpose: To analyze the growth response to growth hormone (GH) therapy in prepubertal patients with Noonan syndrome (NS) harboring different genetic mutations. Methods: Twenty-three patients with prepubertal NS treated at Pusan National University Children's Hospital between March 2009 and July 2017 were enrolled. According to the disease-causing genes identified, the patients with NS were divided into 4 groups. Three groups were positive for mutations of the PTPN11, RAF1, and SOS1 genes. The five genes undetected (FGU) group was negative for PTPN11, RAF1, SOS1, KRAS, and BRAF gene mutations. The influence of genotype was retrospectively analyzed by comparing the growth parameters after GH therapy. Results: The mean chronological age at the start of GH treatment was $5.85{\pm}2.67years$. At the beginning of the GH treatment, the height standard deviation score (SDS), growth velocity (GV), and lower levels of insulin-like growth factor-1 (IGF)-1 levels were not statistically different among the groups. All the 23 NS patients had significantly increased height SDS and serum IGF-1 level during the 3 years of treatment. GV was highest during the first year of treatment. During the 3 years of GH therapy, the PTPN11, RAF1, and SOS1 groups showed less improvement in height SDS, IGF-1 SDS, and GV, and less increase in bone age-to-chronological age ratio than the FGU group. Conclusion: The 3-year GH therapy in the 23 prepubertal patients with NS was effective in improving height SDS, GV, and serum IGF-1 levels. The FGU group showed a better response to recombinant human GH therapy than the PTPN11, RAF1, and SOS1 groups.

Efficacy and safety of growth hormone treatment for children born small for gestational age

  • Hwang, Il Tae
    • Clinical and Experimental Pediatrics
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    • v.57 no.9
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    • pp.379-383
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    • 2014
  • Recombinant growth hormone (GH) is an effective treatment for short children who are born small for gestational age (SGA). Short children born SGA who fail to demonstrate catch-up growth by 2-4 years of age are candidates for GH treatment initiated to achieve catch-up growth to a normal height in early childhood, maintain a normal height gain throughout childhood, and achieve an adult height within the normal target range. GH treatment at a dose of $35-70{\mu}g/kg/day$ should be considered for those with very marked growth retardation, as these patients require rapid catch-up growth. Factors associated with response to GH treatment during the initial 2-3 years of therapy include age and height standard deviation scores at the start of therapy, midparental height, and GH dose. Adverse events due to GH treatment are no more common in the SGA population than in other conditions treated with GH. Early surveillance in growth clinics is strongly recommended for children born SGA who have not caught up. Although high dose of up to 0.067 mg/kg/day are relatively safe for short children with growth failure, clinicians need to remain aware of long-term mortality and morbidity after GH treatment.

Severe trismus due to bilateral coronoid process hyperplasia in growth hormone therapy patient: a case report

  • Lee, Sung-Tak;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.4
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    • pp.249-254
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    • 2012
  • Bilateral coronoid process hyperplasia is a rare condition characterized by an enlarged mandibular coronoid process. The painless progressive reduction of a mouth opening is caused by coronoid process impingement on the posterior aspect of the zygomatic bone. Hyperplasia of the bilateral coronoid process leads to the restriction of a mandibular opening consequent to the impingement of the enlarged coronoid process on the temporal surface of the zygomatic bone or with the medial surface of the zygomatic arch. The process has been diagnosed as developmental hyperplasia. Otherwise, the development of the coronoid process may be associated with growth hormone. This paper describes a case of trismus caused by coronoid hyperplasia in an idiopathic short-stature patient who received growth hormone therapy by somatropin injections.

The Effect of Recombinant Human Growth Hormone on Growth in Children with Nephropathy Receiving Long-term Steroid Therapy (장기간의 스테로이드 치료를 받고 있는 신병증 환아에서 Recombinant Human Growth Hormone의 효과)

  • Kim, Se-Jin;Kim, Sun-Kyoung;Kim, Sung-Do;Cho, Byoung-Soo
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.142-151
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    • 2006
  • Purpose : Growth retardation is one of the serious problems in children with nephropathy requiring long-term steroid therapy. We observed the efficacy and safety of recombinant human growth hormone(rhGH) on the growth in children with long-term steroid therapy. Methods : We studied 60 children(male 47, female 13) with nephropathy who received rhGH(1 U/kg/week) for more than 0.5 years($1.39{\pm}1.12$). Their mean age was 11.0 years($11.17{\pm}2.62$). They received steroid therapy from January 1987 through July 2005, and the mean duration of steroid therapy was $4.32{\pm}2.97$ years. Among the patients, there were 32 nephrotic syndrome, 9 IgA nephropathy, 4 mesangial proliferative glomerulonephritis, 4 focal segmental glomerulosclerosis, 2 Henoch $Sch\ddot{o}nlein$ nephritis, 2 Alport syndrome and 7 other cases. Data were gathered on the growth parameters, such as growth velocity, height standard deviation score(SDS), IGF-1, IGFBP-3, bone mass density(BMD) and general chemistry changes. Results : Height velocity increased significantly with rhGH therapy from $3.29{\pm}1.95$ to $8.66{\pm}3.75$(cm/yr) and height SDS decreased from $-0.72{\pm}0.93$ to $-1.04{\pm}0.86$ at one year after steroid therapy but increased to $-0.55{\pm}0.96$ at one year after rhGH administration(P<0.05). BMD improved from $0.71{\pm}0.14$ to $0.79{\pm}0.15g/cm^2$(P<0.05). IGF-1 increased from $445.09{\pm}138.01$ to $506.62{\pm}181.31ng/mL$(P<0.05). IGFBP-3 decreased from $4073.75{\pm}700.78$ to $3933.61{\pm}789.25ug/L$ numerically, but there was no statistically significant difference(P=0.533). Conclusion : The administration of rhGH in the short stature patients who received long-term steroid therapy showed improvement in growth parameters such as SDS, growth velocity, and BMD without significant side-effects or changes in the biochemical parameters.

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Changes in Plasma Prolactin and Growth Hormone Level and Visual Problem after Radiation Therapy (RT) of Pituitary Adenoma (뇌하수체선종: 방사선치료에 따른 PRL, GH 및 시야변화)

  • Yoon Sei Chul;Kwon Hyung Chul;Oh Yoon Kyeong;Bahk Yong Whee;Son Ho Young;Kang Joon Ki;Song Jin Un
    • Radiation Oncology Journal
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    • v.3 no.1
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    • pp.19-28
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    • 1985
  • Twenty-four cases of pituitary adenoma, 13 males and 11 females with the age ranging from 11 to 65 years, received radiation therapy(RT) on the pituitary area with 6MV linear accelerator during past 25 months at the Division of Radiation Therapy, Kangnam St. Mary's Hospital, Catholic Medical College. Of 24 cases of RT, 20 were postoperative and 4 primary. To evaluate the effect of RT, we analysed the alteration of the endocrinologic tests, neurologic abnormalities, major clinical symptoms, endocrinologic changes and improvement in visual problems after RT. The results were as follows ; 1. Major clinical symptoms were headache, visual defects, diabetes insipidus, hypogonadisms and general weakness in decreasing order of frequency. 2. All but the one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turcica with an invasive tumor mass around supra· and para-sellar area. 3. Endocrinological classifications of the patient were 11 prolactinoma, 4 growth hormone -secreting tumors, 3 ACTH-secreting tumors consisting of one Cushing's disease and two Nelson's syndrome, and 6 nonfunctioning tumors. 4. Eleven of 14 patients, visual problems were improved after treatment but remaining 3 were unchanged. 5. Seven of 11 prolactinomas returned to normal hormonal level after postoperative and primary RT and 3 patients are being treated with bromocriptine (BMCP) but one lost case. 6. Two of 4 growth hormone·secreting tumor returned to normal level after RT but the remaining 2 are being treated with BMCP, as well.

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An Convergence Analysis of the Effect of Growth Hormone Deficiency on the Development of Teeth in short stature Children (성장호르몬결핍이 저신장 소아의 치아발육에 미치는 영향에 대한 융합 분석)

  • Son, Hwa-Kyung;Kang, So-Hee;Lee, Hee-Kyung
    • Journal of the Korea Convergence Society
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    • v.12 no.6
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    • pp.39-47
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    • 2021
  • The purpose of this study is to analyze the differences among short statured children with growth hormone deficiency, idiopathic, and normal children in order to find the effect of growth hormone deficiency on tooth developmental stage. We classified children diagnosed with short stature at the Pediatrics in Yeungnam University Hospital as subjects due to idiopathic and growth hormone deficiency. We analyzed the relationship between short stature and tooth development through the measuring of oral panorama and body index. Only the eruption of lateral incisors showed significant difference between short statured with growth hormone deficiency and idiopathic. Almost all tooth eruption was significantly delayed on short statured children with growth hormone deficiency compared to average group. In conclusion, short stature children with either growth hormone deficiency or idiopathic were affected not only in their somatic stature but also dental maturity. We look forward to this study presenting basic data for orthodontic therapy.