Growth hormone therapy for short stature in adolescents – the experience in the University Medical Unit, National Hospital of Sri Lanka

Introduction: Use of growth hormone therapy (GHT) in adolescents is not common in Sri Lanka. In this study we aimed to assess the response to GHT in adolescents in our setting presenting with short stature.

Materials and methods: This was an observational study carried out at the University Medical Clinic, National Hospital of Sri Lanka. GHT was used for those with growth hormone deficiency (n=15), Turner syndrome (n=5) and Prader Willi syndrome (n=1). All were monitored with anthropometric measurements, IGF-1 and observed for side effects.

Results: Among the 21 adolescents, 15 were males (71.4%). Mean age, height, weight at presentation were 15.0 (10.4-19.1) years, 138.6 (± 7.6) cm and 38.4 (±13.0) kg respectively. Low IGF-1 was found in 16 (76.1%). IGF1 was normal in Turner patients. Impaired response for ITT was seen in 13 (81.3%; n=16). In one patient it was discontinued due to lack of patient cooperation. Follow up period and mean growth velocity were 2.7 – 35.6 months and 7.1 (+3.7) cm/year respectively. In the group with isolated GHD (n=13) significant negative correlation between initial bone age and growth velocity was found but that of initial chronological age and height was not significant. Girls with Turner syndrome showed a mean height velocity of 5.9cm/year with therapy. Side effects were detected in 3 (14.9%) patients which were diabetes mellitus (n=2) and carpal tunnel syndrome (n=1).

Conclusion: Growth hormone replacement therapy is useful in achieving satisfactory height gain in adolescents with short stature due to GHD, Turner syndrome and Prader Willi syndrome and is usually a safe treatment.

DOI: http://dx.doi.org/10.4038/sjdem.v4i1.7255

Sri Lanka Journal of Diabetes, Endocrinology and Metabolism 2014; 4: 49-55