Universität zu Köln

Doerr, H. -G., Bettendorf, M., Binder, G., Doetsch, J., Hauffa, B., Mohnike, K., Mueller, H. L. and Woelfle, J. (2018). Effects of a late start to growth hormone therapy. Results of an expert workshop. Mon.schr. Kinderheilkd., 166 (4). S. 317 - 325. NEW YORK: SPRINGER. ISSN 1433-0474

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Abstract

Short statured children usually reach optimal final height within individual target height range if human growth hormone (HGH) therapy is started early. However, what happens if an early diagnosis is missed and the child is relatively old at start of HGH therapy? The consequences of this have been evaluated on an indication-specific basis by an expert panel of German pediatric endocrinologists using evidence from clinical studies. A late start of HGH therapy is assumed in children with growth hormone deficiency (GHD) beyond the age of 12 years and/or after the onset of puberty. The published information shows markedly reduced efficiency, especially in children with idiopathic GHD. Evidence is insufficient to recommend an increased HGH dose in children with GHD during puberty. Small for gestational age (SGA) children - children of postnatal short stature, who are presented after the onset of puberty - should only receive HGH therapy in well-founded, exceptional cases. Comparable final heights were achieved in girls with Ullrich-Turner syndrome when HGH treatment was started at chronological ages before and after 12 years. Children with Prader-Willi syndrome (PWS) can meet the definition for late start of HGH therapy already beyond four years of age. Early therapy is suggested to optimize psychomotoric development and body composition. There is no data on final height in patients with SHOX syndrome. In patients with chronic renal insufficiency, the effect of HGH therapy started in early puberty is comparable with that started before the onset of puberty. However, the availability of data is limited in this case. In summary, the option of a late start to HGH therapy needs to be analyzed on an individual basis using the data available for the relevant indication. Further examinations and analyses are necessary because the availability of data on questions concerning a late start to HGH therapy is still unsatisfactory.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Doerr, H. -G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bettendorf, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Binder, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Doetsch, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hauffa, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohnike, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, H. L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Woelfle, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-191520
DOI:	10.1007/s00112-017-0267-3
Journal or Publication Title:	Mon.schr. Kinderheilkd.
Volume:	166
Number:	4
Page Range:	S. 317 - 325
Date:	2018
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1433-0474
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FOR-GESTATIONAL-AGE; ULLRICH-TURNER-SYNDROME; PRADER-WILLI-SYNDROME; NEAR-FINAL HEIGHT; ADULT HEIGHT; SHORT CHILDREN; SHOX DEFICIENCY; GH TREATMENT; MOTOR DEVELOPMENT; BODY-COMPOSITION Multiple languages Pediatrics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19152