Treatment of idiopathic growth hormone deficiency: Comparison of growth hormone alone with growth hormone plus thyroxine

摘要

From a series of 36 children with idiopathic hypopituitarism 12 had isolated growth hormone deficiency (IGHD) and 24 multiple pituitary deficiencies (MPHD).9 patients with IGHD on long term treat ment with hGH alone (12.5 U/m2 weekly were compared with 16 MPHD patients receiving T4 substitution (150 μg/m2 daily) in addition.I) Before therapy: a) IGHD: age 7.2,height(SDS) : -3.66;BA (TW-RUS) (SDS) :-2.8; height prediction (TW-RUS age based)(SDS) :-2.67; b) MPHD: age 9.6, height(SDS) :-4.04;BA(SDS) :-3.8; height prediction (SDS) :-2.6.II)Duration of therapy: IGHD:4.8; MPHD : 4.5.III)Height velocities (cm/yr): 1st: IGHD:8.54; MPHD.7.54; 2nd: IGHB 6.59; MPHD 6.96; 3rd: IGHD: 5.68;MPHD:6.89.IV) Bone age progression during total treatment (yr/yr):IGHD 0.95; MPHD:1.09. V) At the end of therapy: a) IGHD:height (SDS): -2.57; prognosis:-1.78, b) MPHD:-2.21, prognosis:-1.44. These results strongly support T4 medication if additional hypothyroidism is suggestive.