Auxological data, pubertal development and final height were analyzed in 25 patients with growth hormone (GH) deficiency who were treated only with pituitary GH in 3 doses/week. 15 patients had a spontaneous onset of puberty and in 10 puberty was induced. The duration of therapy was 7.5 years, the dosage was about 11 U/m2/week and was not changed during puberty. 80% of the patients with induced puberty, but only 33% of the children with spontaneous puberty reached final heights within the 2 SD range. Final height was correlated with height at the start of treatment only in patients with spontaneous puberty, which shows the necessity of early treatment initiation in this group. The lack of this correlation in patients with induced puberty might be attributed to gonadotropin deficiency. Height at the onset of puberty was related to final height only in the group with gonadotropin deficiency. A prediction model for calculation of the first year height velocity which was derived from present treatment procedures showed a too favorable prediction for our patients. The reasons for the insufficient final results may be due to impure GH preparations, suboptimal dosage, low frequency of injections and late onset of therapy.

Keywords:
Hypopituitarism, Growth hormone deficiency and treatment, Puberty, Final height
1.
Ranke MB, Weber B, Bierich JB: Long-term response to human growth hormone in 36 children with idiopathic growth hormone deficiency. Eur J Pediatr 1979;132:221–238.
2.
Burns EC, Tanner JM, Preece MA, Cameron N: Final height and pubertal development in 55 children with idiopathic growth hormone deficiency, treated for between 2 and 15 years with human growth hormone. Eur J Pediatr 1981;137:155–164.
3.
Joss E, Zuppinger K, Schwarz HP, Roten H: Final height of patients with pituitary growth failure and change in growth variables after long term hormonal therapy. Pediatr Res 1983;17:676–679.
4.
Hibi I, Tanaka T: Final height of patients with idiopathic growth hormone deficiency after long term growth hormone treatment. Acta Endocrinol 1989;120:409–415.
5.
Brämswig JH, Schlösser H, Kiese K: Final height in children with growth hormone deficiency. Horm Res 1995;43:126–128.
6.
Rikken B, Massa GG, Wit JM and the Dutch Growth Hormone Working Group: Final height in a large cohort of Dutch patients with growth hormone deficiency treated with growth hormone. Horm Res 1995;43:135–137.
7.
Severi F: Final height in children with growth hormone deficiency. Horm Res 1995;43:138–140.
8.
Bourguignon JP, Vandeweghe M, Vanderschueren-Lodeweyckx M, Malvaux P, Wolter R, Du Caju M, Ernould C: Pubertal growth and final height in hypopituitary boys: A minor role of bone age at onset of puberty. J Clin Endocrinol Metab 1986;63:376–382.
9.
Tanner JM: Growth at Adolescence, ed 2. Oxford, Blackwell, 1962.
10.
Frisch H, Waldhauser F, Havelec L, Schober E, Stögmann W, Spona J, Schernthaner G: Gonadotropin responsiveness to LHRH in prepubertal and pubertal patients with growth hormone deficiency. Acta Paediatr Scand 1982;71:579–582.
11.
Frisch H, Herkner J, Schober E, Stögmann W, Waldhauser F, Weissel M: Prolactin and thyrotropin response to thyrotropin releasing hormone in growth hormone deficiency. Arch Dis Child 1982;57:769–773.
12.
Prader A, Largo RH, Molinari L, Issler C: Physical growth of Swiss children from birth to 20 years of age. Helv Paediatr Acta 1989 (suppl 52):1–125.
13.
Ranke MB: Towards a consensus on the definition of idiopathic short stature. Horm Res 1996;45(suppl 2):64–66.
14.
Greulich WW, Pyle SI: Radiographic Atlas of Skeletal Development of the Hand and Wrist, ed 2. Stanford, Stanford University Press, 1959.
15.
Trygstad O, Foss I: Preparation of purified human growth hormone and a crude human pituitary gonadotrophin. Acta Endocrinol 1971;66:478–490.
16.
Ranke MB, Guilaud O: Growth response in prepubertal children with idiopathic growth hormone deficiency during the first year of treatment with human growth hormone. Analysis of the Kabi International Growth Study. Acta Paediatr Scand Suppl 1990;370:122–130.
17.
Illig R: Growth hormone (GH) antibodies in patients treated with different preparations of human GH. J Clin Endocrinol Metab 1970;31:679–688.
18.
Kastrup KW, Christiansen JS, Koch Andersen J, Orskov H: Increased growth rate following transfer to daily s.c. administration of growth hormone in growth hormone deficient children. Acta Endocrinol (Copenh) 1983;104:148–152.
19.
Stubbe P, Frasier SD, Stahnke N, Cacciari E, Job JC, Preece M, Frisch H, Zachmann M, Zeisel HJ: Growth response to recombinant human growth hormone in mammalian cell origin in prepubertal growth hormone deficient children during the first two years of treatment. Horm Res 1992;37(suppl 2):28–36.
20.
Hibi I, Tanaka T, Tanae A, Kagawa J, Hashimoto N, Yoshizawa A, Shizume K: The influence of gonadal function and the effect of gonadal suppression treatment on final height in growth hormone (GH)-treated GH-deficient children. J Clin Endocrinol Metab 1989;69:221–226.
21.
Van den Broeck J, Vanderschueren-Lodeweyckx M, Eggermont E: Prediction of final height in boys with non-tumerous hypopituitarism. Eur J Pediatr 1988;147:245–247.
22.
Blethen SL, Compton P, Lippe BM, Rosenfeld RG, August GP, Johanson A: Factors predicting the response to growth hormone (GH) therapy in prepubertal children with GH deficiency. J Clin Endocrinol Metab 1993;76:574–579.
1998
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