Growth Enhancement by Dopaminergic Therapy in Children with Intrauterine Growth Retardation*

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Abstract
Stimulation of growth velocity in hypopituitary children by dopaminergic therapy (DA), i.e. either L-dopa or bromocriptine was reported in a previous study. The purpose of DA stimulated endogenous GH release and growth in children with intrauterine growth retardation (IUGR), who also had microcephaly and psycho-motor retardation was determined. The effect of DA on serum LH [luteinizing hormone], FSH, gonadal steroids, cortisol, T4, [thyroxine] and TSH also was examined. Six prepubertal children [4 girls and 2 boys; bone age (BA), 1.5-4 yr] with IUGR were divided into 2 study groups. Group I (n = 3) received L-dopa (15 mg/kg) orally every 6 h for 6 mo. Group II (n = 3) received bromocriptine (1.25 mg) orally every 12 h for 6 mo. At the end of the 6 mo. of DA therapy, both groups received human GH [growth hormone] (hGH) (0.1 IU/kg) i.m. thrice weekly for 6 mo. The growth rate in group I was 6.5 .+-. 0.1 (.+-. SD) cm/yr after 6 mo. of DA compared with a pretreatment growth rate of 4.1 .+-. 0.7 cm/yr. Individual increments ranged from 38-80%. All 3 children achieved normal growth rates for their BA. Similarly, the growth rate in group II increased to 7.7 .+-. 0.9 cm/yr from a pretreatment growth velocity of 4.2 .+-. 1.6 cm/yr. The growth increments of group II ranged from 43-133%. Two children of group II achieved normal growth rates for their BA, and all had a significant increase in height (P < 0.05). Four of the 6 children achieved normal growth velocities after 6 mo. of hGH therapy. Five of the 6 children significantly increased their mean hGH responses to L-dopa or bromocriptine during chronic DA therapy compared with the pretreatment period. Maximum serum hGH values in group I increased from a pretreatment mean (and range) of 12 .+-. 4 (.+-. SE) ng/ml (5-18 ng/ml) to 46 .+-. 12 ng/ml (21-64 ng/ml). The maximum hGH concentrations in group II increased from a pretreatment mean and range of 21 .+-. 7 ng/ml (11-34 ng/ml) to 48 .+-. 4 (42-56 ng/ml). Also, 4 of the 6 children had correspondingly increased somatomedin-C concentrations after DA therapy. Apparently, dopaminergic therapy, i.e. L-dopa or bromocriptine, induced linear growth in patients with a form of IUGR associated with microcephaly and psychomotor retardation. DA therapy perhaps may be useful in treating other various forms of IUGR.

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