scholarly journals Thyroid Profile abnormalities of RHGH treated children

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
W A Mouharam ◽  
D A Soliman
Keyword(s):  
Growth Hormone ◽  
Thyroid Function ◽  
Optimal Growth ◽  
Hormone Treatment ◽  
Hormone Deficiency ◽  
Height Velocity ◽  
Free T4 ◽  
Thyroid Profile ◽  
The Impact ◽  
Rhgh Treatment

Abstract Objective Normal thyroid function is important for optimal growth. Contradictory studies are available on the impact of rhGH treatment on thyroid function. Study aim is to evaluate the effect of rhGH treatment on thyroid function. Methods Study involved 102 euthyroid, prepubertal patients with growth hormone deficiency treated with rhGH. For all children, basal thyroid function, height, height velocity after 1 year of treatment, thyroid function every 3 months during the first year of treatment, all were performed. Results At 3 months of treatment 12 patients had elevated TSH, with or without low free T4. The remaining patients had normal free T4 (but lower than the basal one in most of the patients), with no TSH difference. The latter results were normalized at 1 year. Growth velocity was significantly lower in patients with hypothyroidism. Conclusion Thyroid profile may be affected in patients with short stature on growth hormone treatment which may negatively impact treatment response.

scholarly journals Thyroid Hormone Changes Related to Growth Hormone Therapy in Growth Hormone Deficient Patients

2021 ◽  
Vol 10 (22) ◽  
pp. 5354
Author(s):  
Anna Małgorzata Kucharska ◽  
Ewelina Witkowska-Sędek ◽  
Małgorzata Rumińska ◽  
Beata Pyrżak
Keyword(s):  
Growth Hormone ◽  
Thyroid Hormone ◽  
Thyroid Function ◽  
Hormone Receptors ◽  
Recombinant Human Growth Hormone ◽  
Human Growth ◽  
Hormone Deficiency ◽  
Central Hypothyroidism ◽  
Rhgh Therapy ◽  
The Impact

The alterations in thyroid function during recombinant human growth hormone (rhGH) treatment have been reported by many authors since this therapy became widely available for patients with growth hormone deficiency (GHD). Decrease of thyroxine level is the most frequent observation in patients treated with rhGH. This paper presents literature data describing changes in thyroid function related to rhGH therapy and a current explanation of mechanisms involved in this phenomenon. The effect of GH on the hypothalamic-pituitary-thyroid (HPT) axis is dependent on a multilevel regulation beginning from influence on the central axis, thyroid, and extra-thyroidal deiodinases activity as well as the impact on thyroid hormone receptors on the end. Changes in central and peripheral regulation could overlap during rhGH therapy, resulting in central hypothyroidism or an isolated slight deficiency of thyroxine. The regular monitoring of thyroid function is recommended in patients treated with rhGH and the decision of levothyroxine (L-thyroxine) supplementation should be made in the clinical context, taking into account thyroid hormone levels, as well as the chance for satisfactory growth improvement.

scholarly journals Comparison of Quality of Life Responses From Caregiver and Children Aged ≥7 Years Using the Quality of Life in Short Stature Youth (QoLISSY) Questionnaire, Following 12 Months of Growth Hormone Treatment With Either a Weekly Somatrogon or a Daily Genotropin Injection Schedule

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A674-A674
Author(s):  
Jane Loftus ◽  
Julia Quitmann ◽  
Srinivas Valluri ◽  
Aleksandra Pastrak ◽  
Lawrence Reiter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Growth Hormone ◽  
Short Stature ◽  
Recombinant Human Growth Hormone ◽  
Human Growth ◽  
Hormone Treatment ◽  
Hormone Deficiency ◽  
Height Velocity ◽  
Controlled Clinical Trial

Abstract Objective: Paediatric growth hormone deficiency (pGHD) affects 1/4,000 children. Treatment with daily sub-cutaneous injections of recombinant human growth hormone (r-hGH) increase height velocity and quality of life (QoL). A recent randomised controlled clinical trial (NCT02968004) evaluated the efficacy/safety of weekly Somatrogon (hGH-CTP) and daily Genotropin in pGHD. QoL (an exploratory endpoint) was evaluated using the validated Quality of Life in Short Stature Youth (QoLISSY) questionnaire, which includes three subscales (physical, social, emotional) and total score. Methods: The QoLISSY core module was administered to patients (aged 3-11 years [girls], 3-12 years [boys]) and parents in US, UK, Australia, New Zealand, Belarus, Russia, Ukraine and Spain, at Baseline (BL) and 12 months after treatment start. The QoLISSY-CHILD was completed by children aged ≥7 years; QoLISSY-PARENT was completed by the Caregiver for children <7 years, and for some children aged ≥7 years. We report here only the QoLISSY results for children aged ≥7 years (reported from either child or parent). Results: For Total QoLISSY-PARENT, for children aged ≥7 years in the Somatrogon group (N=26), mean scores are 53.65 (BL) and 65.52 (month 12) with mean change of 13.01 (95% Confidence Interval [CI]: 3.99, 22.02). In the Genotropin group (N=28), mean scores are 55.89 (BL) and 63.66 (month 12) with mean change of 6.60 (CI:-0.21, 13.40). For Total QoLISSY-CHILD in the Somatrogon group (N=35), mean scores are 61.48 (BL) and 74.69 (month 12) with mean change of 13.00 (CI: 5.81, 20.19). In the Genotropin group (N=35), these scores are 60.96 (BL) and 69.03 (Month 12) with mean change of 7.84 (CI: 2.71, 12.97). Scores of >70 indicate a good QoL. Conclusions: QoL in children aged ≥7 years improved, following 12 months of either treatment, whether this was reported by caregiver or child. However, these data show that the baseline scores and 12 month scores from the QoLISSY-PARENT in both treatment groups were numerically lower than those reported by the child. This is consistent with the literature¹, in which the caregivers generally report lower QoL scores on behalf of the child. ¹Explaining parent-child (dis)agreement in generic and short stature-specific health-related quality of life reports: do family and social relationships matter? Quitmann et al Health and Quality of Life Outcomes 2016 vol 14, Article 150

scholarly journals Factors predictive of the short- and long-term efficacy of growth hormone treatment in prepubertal children with chronic renal failure. The German Study Group for Growth Hormone Treatment in Chronic Renal Failure.

1998 ◽  
Vol 9 (10) ◽  
pp. 1899-1907
Author(s):  
D Haffner ◽  
E Wühl ◽  
F Schaefer ◽  
R Nissel ◽  
B Tönshoff ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Growth Response ◽  
Hormone Treatment ◽  
Height Velocity ◽  
Target Height ◽  
Short And Long Term ◽  
Rhgh Treatment

To evaluate the growth-stimulating effects of short- and long-term treatment with recombinant human growth hormone (rhGH) in growth-retarded children with chronic renal failure (CRF), 103 prepubertal children with CRF on conservative treatment (n = 74) or dialysis (n = 29) were treated with rhGH for up to 5 yr. rhGH treatment persistently increased standardized height (+ 1.6 SD scores) and predicted adult height (+7.7 cm, Tanner method) during the first 3 treatment years (P < 0.001 versus baseline), followed by percentile parallel growth during continued treatment. Both standardized height and predicted adult height were significantly more increased in conservatively treated than in dialyzed children (P < 0.001). Age, GFR, target height, and prestudy growth rate were identified as independent predictors of the response to rhGH treatment during the first and second treatment year. GFR and target height were positively correlated with the change in height SD score and the change in absolute or age-standardized height velocity. Age affected the growth response depending on which outcome measure was used: Although the first-year change in height SD score was inversely correlated with age, the change in absolute height velocity was independent of age, and the change in standardized height velocity was positively correlated with age. The growth response during the first treatment year positively predicted the long-term response. In conclusion, the short- and long-term growth response to rhGH treatment in prepubertal growth-retarded children with CRF is significantly affected by age, GFR, target height, and the pretreatment growth rate. Therefore, rhGH should be preferably started at a young age, and early in the course of CRF.

Recombinant Human Growth Hormone (rhGH) Treatment of Children Undergoing Peritoneal Dialysis

1990 ◽  
Vol 10 (3) ◽  
pp. 209-214 ◽  
Author(s):  
Richard N. Fine ◽  
Vera H. Koch ◽  
M. Ines Boechat ◽  
Barbara H. Lippe ◽  
Pauline A. Nelson ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Peritoneal Dialysis ◽  
Growth Velocity ◽  
Recombinant Human Growth Hormone ◽  
Standard Deviation Score ◽  
Hormone Deficiency ◽  
Height Velocity ◽  
Recombinant Growth Hormone ◽  
Rhgh Therapy ◽  
Rhgh Treatment

The authors studied the effect of recombinant growth hormone (rhGH) treatment on 5 growth retarded children, age 21/12 to 178/12 years, who had end-stage renal disease (ESRD) and were undergoing continuous cycling peritoneal dialysis (CCPD). Patients received 0.125 mg/kg of subcutaneous rhGH 3 times weekly. Accelerated height velocity compared to the previous year of CCPD was noted in 2 patients and improvement in the standard deviation score (SDS) as a parameter of improved growth velocity was noted in a third patient. This was associated with an increase in weight and improvement in the midarm muscle circumference (MAMC) suggesting an anabolic effect of rhGH treatment. Bone age advancement was consistent with the period of observation; no advancement greater than that expected for the increase in chronological age was observed. No significant side effects were attributable to rhGH therapy. These preliminary results indicate some growth retarded children without growth hormone deficiency with ESRD undergoing CCPD may respond to exogenous rhGH therapy with an acceleration in growth velocity: However, the failure to achieve uniform acceleration of height velocity indicates the need for controlled studies before rhGH can be recommended for all growth retarded children with ESRD undergoing peritoneal dialysis.

scholarly journals Insulin-like growth factor-1 level is a poor diagnostic indicator of growth hormone deficiency

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hideyuki Iwayama ◽  
Sachiko Kitagawa ◽  
Jyun Sada ◽  
Ryosuke Miyamoto ◽  
Tomohito Hayakawa ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Factor ◽  
Diagnostic Accuracy ◽  
Growth Hormone Deficiency ◽  
Screening Test ◽  
Characteristic Curve ◽  
Hormone Deficiency ◽  
Height Velocity ◽  
Insulin Like Growth Factor ◽  
Predictive Values

AbstractWe evaluated the diagnostic accuracy of insulin-like growth factor-1 (IGF-1) for screening growth hormone deficiency (GHD) to determine the usefulness of IGF-1 as a screening test. Among 298 consecutive children who had short stature or decreased height velocity, we measured IGF-1 levels and performed growth hormone (GH) secretion test using clonidine, arginine, and, in cases with different results of the two tests, L-dopa. Patients with congenital abnormalities were excluded. GHD was defined as peak GH ≤ 6.0 ng/mL in the two tests. We identified 60 and 238 patients with and without GHD, respectively. The mean IGF-1 standard deviation (SD) was not significantly different between the GHD and non-GHD groups (p = 0.23). Receiver operating characteristic curve analysis demonstrated the best diagnostic accuracy at an IGF-1 cutoff of − 1.493 SD, with 0.685 sensitivity, 0.417 specificity, 0.25 positive and 0.823 negative predictive values, and 0.517 area under the curve. Correlation analysis revealed that none of the items of patients’ characteristics increased the diagnostic power of IGF-1. IGF-1 level had poor diagnostic accuracy as a screening test for GHD. Therefore, IGF-1 should not be used alone for GHD screening. A predictive biomarker for GHD should be developed in the future.

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