Biological Significance of Anti-GH Antibodies in Children Treated with rhGH

2019 ◽  
Vol 91 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Gerhard Binder ◽  
Laura Heidenreich ◽  
Dirk Schnabel ◽  
Desirée Dunstheimer ◽  
Rudolf Oeverink ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Recombinant Human Growth Hormone ◽  
Biological Significance ◽  
Positive Test ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Test Results ◽  
Midline Defect ◽  
Group A ◽  
Group B

Background: The occurrence of antidrug antibodies is common in children treated with recombinant human growth hormone (rhGH). However, their clinical significance is unclear. Objective: This study aimed to examine the clinical significance of anti-GH antibodies by analyzing the phenotype of patients who tested positive in relation to the quantity of anti-GH antibodies. Method: In this laboratory-based retrospective study encompassing a time span of 6 years, all positive samples were identified, and senders were contacted. Anti-GH antibodies were measured using a radioprecipitation assay; positive samples underwent a confirmatory assay. Results: Out of a total of 104 samples from 66 patients, positive test results were found in 28 samples from 13 patients. Clinical data were available from all but one. The group with positive test results comprised 6 patients with a normal response to GH provocative tests (group A) and 6 with an insufficient response or with isolated GH deficiency (IGHD) type 1A (group B). Diagnoses in group A were neurosecretory dysfunction, bioinactive GH syndrome and constitutional delay of growth and puberty. Diagnoses in group B were IGHD type 1A, septo-optic dysplasia, and cerebral midline defect with multiple pituitary hormone deficiency. Insufficient growth response to rhGH was absent except in one sibling pair with IGHD type 1A and a patient with cerebral midline defect. These patients had the highest concentrations of anti-GH antibodies. Conclusions: The biological significance of anti-GH antibodies seems to be limited to patients with high concentrations of anti-GH antibodies. For all other patients, we recommend a careful “wait and see” strategy and monitoring antibody titers.

Transient impairment or delay of urinary trihydroxypregnanone (THS) response to metyrapone in boys with delayed adolescence and in patients with isolated growth hormone deficiency

1982 ◽  
Vol 99 (2) ◽  
pp. 166-173 ◽  
Author(s):  
M. Zachmann ◽  
D. Tassinari ◽  
W. Sorgo ◽  
G. U. Exner ◽  
B. Kempken ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Single Dose ◽  
Growth Hormone Deficiency ◽  
Bone Age ◽  
Urine Samples ◽  
Hormone Deficiency ◽  
Cortisol Response ◽  
Transient Impairment ◽  
Group A ◽  
Group B

Abstract. Twentythree boys with delayed adolescence (age 15.7 ± 2.0, bone age 12.4 ± 2.1 years) were studied. Their cortisol response to insulin was normal. After oral metyrapone (500 mg/m2 by mouth) one to three consecutive 12 h urine samples were collected for analysis of THS. Thirtyseven tests with 37 first, 21 second, and 11 third samples were carried out. The results could be divided into two main groups: 25 tests (group A) were subnormal in the first sample, 12 of them with a very weak (40 ± 8 μg/m2/12 h) and 13 with an insufficient (191 ± 16 μg/m2/12 h) THS response. Values in the second and third sample were higher, indicating a dealyed response. In 12 tests (group B), the results were normal (1016 ± 143 μg/m2/12 h) in the first and lower in the second and third samples. In three patients with repeated tests, there was improvement with increasing bone age. The THS-responses to metyrapone did not correlate with those of growth hormone, gonadotrophins, and TSH to stimuli. It is concluded that the THS-response to a single dose of metyrapone may be temporarily insufficient or delayed in delayed adolescence. We interpret this finding as showing transiently reduced or slow hypothalamic responsiveness.

scholarly journals A Comparative Clinical Study of Trikarshika Kwatha with and without Lifestyle Modification in the Management of Vatarakta with Special Reference to Hyperuricaemia

2021 ◽  
pp. 10-19
Author(s):  
Md Tanzil Ansari ◽  
Sukumar Ghosh ◽  
Shailendra Kumar Singh
Keyword(s):  
Clinical Study ◽  
Lifestyle Modification ◽  
Test Results ◽  
Before And After ◽  
Comparative Clinical Study ◽  
Group A ◽  
Group B ◽  
High Level ◽  
Urate Crystals

Nowadays, people are more vulnerable to metabolic disorders due to their faulty dietary and behavioural habits. One such disorder is Vatarakta which causes functional impairment due to involvement of Sandhi (joints). It is manifested by Ruk, Toda, Sparsha asahatva, Shopha, Raga, Daha and Stabdhata in Sandhi. Vatarakta can be correlated with Hyperuricaemia or Gout due to similarity in their clinical features. Hyperuricaemia is defined as abnormally high level of uric acid in blood (i.e. >6mg/dl in female and >7mg/dl in male). On the other hand, Gout is an inflammatory response to monosodium urate crystals formed secondary to hyperuricaemia. Aims and objectives: 1. To evaluate the effectiveness of Trikarshika kwatha and lifestyle modification in the management of Vatarakta. 2. To compare the effects of Trikarshika kwatha with and without lifestyle modification in the management of Vatarakta. Materials and methods: Raw herbs of the research formulation were collected after proper identification and Kwatha was prepared for oral administration. For the clinical study, total 60 patients were selected on the basis of selection criteria. Selected patients were randomly divided into two groups. (i) Group A: 30 patients were treated with Trikarshika kwatha. (ii) Group B: 30 patients were treated with Trikarshika kwatha along with Lifestyle modification. Individual patient was treated for 45 days along with follow up at the interval of every 15 days. To assess the effectiveness of treatment, scoring pattern was followed for subjective and objective parameters. They were assessed before and after treatment. The collected data were analysed statistically by using Paired t-test. Results: On the basis of all statistical data, it can be said that patients of Group B showed better results in all parameters in comparison to patients of Group A. Conclusion: Both Trikarshika kwatha and Lifestyle modification are affective but Trikarshika kwatha with Lifestyle modification is more effective than Trikarshika kwatha without Lifestyle modification in the management of Vatarakta.

scholarly journals Low FT4 Concentrations around the Start of Recombinant Human Growth Hormone Treatment: Predictor of Congenital Structural Hypothalamic-Pituitary Abnormalities?

2018 ◽  
Vol 89 (2) ◽  
pp. 98-107 ◽  
Author(s):  
Laura van Iersel ◽  
Hanneke M. van Santen ◽  
Gladys R.J. Zandwijken ◽  
Nitash Zwaveling-Soonawala ◽  
Anita C.S. Hokken-Koelega ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Treatment ◽  
Recombinant Human Growth Hormone ◽  
Human Growth ◽  
Hormone Treatment ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Gh Treatment ◽  
Central Hypothyroidism ◽  
Pituitary Disease

Background: Growth hormone (GH) treatment may unmask central hypothyroidism (CeH). This was first observed in children with GH deficiency (GHD), later also in adults with GHD due to acquired “organic” pituitary disease. We hypothesized that newly diagnosed CeH in children after starting GH treatment for nonacquired, apparent isolated GHD points to congenital “organic” pituitary disease. Methods: Nationwide, retrospective cohort study including all children with nonacquired GHD between 2001 and 2011 in The Netherlands. The prevalence of CeH, hypothalamic-pituitary (HP) abnormalities, and neonatal congenital hypothyroidism screening results were evaluated. Results: Twenty-three (6.3%) of 367 children with apparent isolated GHD were prescribed LT4 for presumed CeH within 2 years after starting GH treatment. Similarly to children already diagnosed with multiple pituitary hormone deficiency, 75% of these 23 had structural HP abnormalities. In children not prescribed LT4, low pre- or post-GH treatment FT4 concentrations were also associated with structural HP abnormalities. Neonatal screening results of only 4 of the 23 children could be retrieved. Conclusion: In children with nonacquired, apparent isolated GHD, a diagnosis of CeH after, or a low FT4 concentration around the start of GH treatment, is associated with congenital structural HP abnormalities, i.e., “organic” pituitary disease. Neonatal values could not be judged reliably.

A newborn with combined pituitary hormone deficiency developing shock and sludge

2017 ◽  
Vol 30 (12) ◽  
Author(s):  
Yasuhiro Ueda ◽  
Hayato Aoyagi ◽  
Toshihiro Tajima
Keyword(s):  
Recombinant Human Growth Hormone ◽  
Brain Magnetic Resonance Imaging ◽  
Human Growth ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Pituitary Hormone Deficiency ◽  
Combined Pituitary Hormone Deficiency ◽  
Respiratory Management ◽  
Respiratory Disturbance ◽  
Male Neonate

AbstractA male neonate was born at 41 weeks of gestation with a birth weight of 3320 g. Artificial respiratory management was required due to respiratory disturbance 1 h after birth, and subsequently catecholamine-refractory low cardiac output-induced shock occurred. Severe combined pituitary hormone deficiency (CPHD) was considered based on the presence of his respiratory disturbance, hypoglycemia and micropenis. After hydrocortisone (HDC) administration, circulatory dynamics rapidly improved. Brain magnetic resonance imaging (MRI) showed aplasia of the anterior pituitary gland and ectopic posterior gland. γ-Glutamyltranspeptidase (γ-GTP) increased from day 10 after birth and direct bilirubin increased from day 18. On ultrasonography, sludge filling the common bile duct and gall bladder was observed. After initiating treatment with both ursodeoxycholic acid and recombinant human growth hormone (rhGH), cholestasis improved and the sludge disappeared at 3 months after birth. In newborns with CPHD, severe central adrenal insufficiency might induce cardiogenic shock after birth. Early diagnosis and intervention are necessary.

Effect of GnRHa 3.75 mg subcutaneously every 6 weeks on adult height in girls with idiopathic central precocious puberty

2015 ◽  
Vol 28 (7-8) ◽  
Author(s):  
Yan Liang ◽  
Hong Wei ◽  
Jie Li ◽  
Ling Hou ◽  
Jianling Zhang ◽  
...  
Keyword(s):  
Precocious Puberty ◽  
Adult Height ◽  
Recombinant Human Growth Hormone ◽  
Central Precocious Puberty ◽  
Healthy Children ◽  
Idiopathic Central Precocious Puberty ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Age Of Menarche

AbstractTo evaluate the long-term efficacy of triptorelin 3.75 mg subcutaneously every 6 weeks on the final height in girls with idiopathic central precocious puberty (ICPP).Forty females with ICPP received triptorelin 3.75 mg every 6 weeks subcutaneously in our hospital from 2002 to December 2010 and reached their final heights were enrolled. These patients were treated with triptorelin alone (group A, n=17) or triptorelin+recombinant human growth hormone (rhGH) (group B, n=23). Height, weight, annual growth velocity (GV), sexual development, predicted adult height (PAH), and adverse effects were observed. Bone age (BA) and height standard deviation score (SDS) were monitored yearly.Final adult heights (FAHs) were 159.81±1.20 cm and 161.01±1.02 cm in group A vs. group B, which exceeded target height (THt) by 1.51±1.04 cm, 4.86±0.94 cm, respectively. The values of (FAH-THt), (FAH-PAH posttreatment) showed significant difference between the two groups (p<0.05). FAH was positively correlated with Ht SDS-BA at the end of treatment, THt, course of rhGH treatment, and age of menarche (r2=0.66). Body mass index (BMI) increased after treatment in group B. However, there was no significant tendency of increase compared with healthy children at the same age. Ages of menarche and time to menarche from discontinuation were 11.74±0.16 vs. 12.18±0.15 years and 17.41±1.69 vs. 14.71±1.04 months in two groups.The FAH was improved effectively by triptorelin 3.75 mg subcutaneously every 6 weeks, and more height gain could be achieved when rhGH was used concomitantly. BMI maintained steadily and ovarian function restored quickly after treatment discontinuation with the age of menarche similar to that of normal children. Neither significant side effect nor polycystic ovary syndrome was observed.

scholarly journals EFFECT OF TESTICULAR TORSION ON SPERMATOZOA IN CONTRALATERAL EPIDIDYMIS

2012 ◽  
Vol 19 (2) ◽  
Author(s):  
Sawkar Vijay Pramod ◽  
Suwandi Sugandi ◽  
Aaron Tigor Sihombing ◽  
Marselina Tan
Keyword(s):  
Wistar Rats ◽  
Testicular Torsion ◽  
Sperm Morphology ◽  
Test Results ◽  
Chi Square ◽  
Exact Test ◽  
Group A ◽  
Group B ◽  
Fischer Exact Test ◽  
Morphology Changes

Objective: To determine the abnormality of spermatozoa in the contralateral epididymis after unilateral testicular torsion. Material & method: Twenty wistar rats were divided into two groups i.e. Group B (sham procedure) Group A (torsio and orchiectomy 24 hours later), and contralateral epididymectomy was performed a month later. Spermatozoa in the contralateral epididymis are extracted and analyzed by an experienced biologist. Data were analyzed using Chi-square or Fischer exact test. Results: Sperm morphology changes in group B is higher than Group A (6,6% vs 0,5%, p = 0,009). Conclusion: Unilateral testicular torsion causes sperm abnormal morphology in the contralateral epididymis. Keywords: Unilateral testicular torsion, contralateral epididimal spermatozoa.

scholarly journals Comparison Of Diacerein-Ginger With Diacerein Alone In Treating Knee Osteoarthritis

2019 ◽  
Vol 09 (04) ◽  
pp. 308-311
Author(s):  
Mehtab Munir ◽  
Shahid Mustafa Memon ◽  
Sajid Abbas Jaffri ◽  
Khalid Mustafa Memon
Keyword(s):  
Knee Osteoarthritis ◽  
P Value ◽  
Womac Pain ◽  
Test Results ◽  
Knee Oa ◽  
Significant Difference ◽  
Group A ◽  
Insignificant Difference ◽  
Group B ◽  
Pain At Rest

Objective: To compare clinical efficacy of diacerein-ginger with diacerein alone in treating knee osteoarthritis. Duration and place of study: It was a randomized clinical trial conducted from 21st September 2018 to 31stMarch 2019, in medical OPD of a private hospital in Karachi. Methodology: 60 diagnosed patients of knee osteoarthritis were included in this study. Male and female patients 50 years of age, fulfilling the inclusion criteria and after written informed consent experienced a wash-out period of 72 hours. These patients were systematically randomized into 2 groups each having 30 members. Group A received capsule Diacerein 50mg + capsule Ginger 550 mg twice daily and group B received capsule Diacerein 50mg twice daily, for 12 weeks. Parameters checked at 0, 6 and 12 weeks were: Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, pain at rest and movement (Visual Analogue Scale). Comparison of the two groups was done by independent t-test. Results: Among 60 patients; 20 (33.33 %) were males and 40 (66.66%) were females. 4 patients in group A and 4 in B, dropped out during the study. Comparison of group A with group B in WOMAC and pain (at rest and movement) scores showed insignificant difference at day 0 before prescription of the drugs. However comparison showed highly significant difference (P-value < 0.001) between the two groups in WOMAC, pain at rest and movement scores at the end of 6th and 12th weeks of intervention. Conclusion: Diacerein-Ginger is clinically more efficacious for management of knee OA than Diacerein alone

scholarly journals Application Value of Coagulation Function Test in Prognosis of Patients with Cardiovascular and Cerebrovascular Diseases

2021 ◽  
Vol 9 (4) ◽  
pp. 89
Author(s):  
Jing Luo
Keyword(s):  
Cerebrovascular Diseases ◽  
Good Prognosis ◽  
Control Group ◽  
Study Group ◽  
Test Results ◽  
Coagulation Function ◽  
Significant Difference ◽  
Function Test ◽  
Group A ◽  
Group B

<p><span lang="EN-US">Objective: to explore the application value of coagulation function test in the prognosis of patients with cardiovascular and cerebrovascular diseases. Methods: from December 2018 to December 2019, 100 patients with cardiovascular and cerebrovascular diseases were randomly selected as the study group. According to the follow-up results of patients, they were divided into study group A (good prognosis, n = 64) and study group B (disability or death, n = 36) 100 subjects served as the control group. The test results of coagulation function of the two groups were analyzed retrospectively. The test results of the study group before and after treatment were compared with those of the control group, and the test results of the study group A and study group B after treatment were compared. Results: the coagulation function of the study group after treatment was significantly improved compared with that before treatment (P &lt; 0.05), and there was a significant difference between the two groups before treatment (P &lt; 0.05), and there was no difference after treatment (P &gt; 0.05); after treatment, the coagulation function of study group A and study B was significantly different (P &lt; 0.05). Conclusion: coagulation function test has a certain application value for the prognosis of patients with cardiovascular and cerebrovascular diseases, and can be used as an index to judge the patient’s condition and treatment effect, which has good application value in clinical practice.</span></p>

scholarly journals Isolated Growth Hormone Deficiency and Idiopathic Short Stature: Comparative Efficiency after Growth Hormone Treatment up to Adult Height

2021 ◽  
Vol 10 (21) ◽  
pp. 4988
Author(s):  
Ana-Belen Ariza-Jimenez ◽  
Isabel Leiva Gea ◽  
Maria Jose Martinez-Aedo Ollero ◽  
Juan Pedro Lopez-Siguero
Keyword(s):  
Growth Hormone ◽  
Short Stature ◽  
Hormone Treatment ◽  
Treated Group ◽  
Idiopathic Short Stature ◽  
Hormone Deficiency ◽  
Comparative Efficiency ◽  
Height Gain ◽  
Group A ◽  
Group B

Introduction: Treatment with growth hormone (GH) is not approved for idiopathic short stature (ISS) in Europe. Objectives: To compare the growth of children treated with isolated GH deficiency (IGHD) vs. ISS-treated and untreated children. Methods: A retrospective descriptive study of patients treated in the last 14 years for IGHD (Group A), in comparison with ISS-treated (Group B) and untreated (Group C) subjects. Results: Group A had 67 males, who showed a height gain of 1.24 SD. Group B had 30 boys, who showed a height gain of 1.47 SD. Group C had 42 boys, who showed an improvement of 0.37 SD. The final heights were −1.52 SD, −1.31 SD, and −2.03 SD, respectively. Group A and C did not reach their target heights (with differences of 0.27 SD and 0.59 SD, respectively). Group B surpassed their target height by 0.29 SD. Conclusions: The final heights of the IGHD and treated ISS are similar. Treated groups were taller than untreated groups.

scholarly journals Is Novel Coronavirus Novel: Covid-19, A Pandemic or An Endemic?

2020 ◽  
Author(s):  
Sangam Banerjee
Keyword(s):  
Disease Progression ◽  
Herd Immunity ◽  
Threshold Value ◽  
Acquired Immunity ◽  
Test Results ◽  
Serological Survey ◽  
Previous Infection ◽  
Group A ◽  
Group B ◽  
Novel Coronavirus

We have analysed the death and recovery rate of Covid-19 disease progression. From the analysis, we have argued that the pandemic is over in certain countries (labelled as group-A) and for other countries (labelled as group-B) the disease appears to remain as endemic. Taking into account the serological survey (sero-survey) test results obtained by certain groups and comparing it with herd immunity threshold value one can infer that the low number of infection for group-B is either due to acquired immunity by some previous infection by other coronavirus or due to innate immunity towards this infection. This effect is stronger for group-B to slow the progress of the disease to such an extent resulting in flattening of the disease progression curve compared to group-A.

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