USE OF GROWTH-HORMONE IN CHILDREN WITH SHORT STATURE AND NORMAL GROWTH-HORMONE SECRETION - A GROWING PROBLEM

The ethical, economic, psychologic, social, and growth attainment outcome issues related to the use of GH therapy in normal children with short stature ave discussed. Although some short children accelerate their growth velocity with GH treatment, the limited available data do not suggest a significant benefit in final height attainment. An international survey of 99 normal short children treated with GH for at least 3 years reported a net improvement in mean height gain of <1 cm/year. Only in one-third was the result considered very good or good; 40% stated that there was no benefit. Thus, it seems unlikely that GH will dramatically increase final height in short children. On this basis, the use of GH for the treatment of the normal child with short stature outside of carefully controlled clinical trials cannot be recommended at present.