Long Term Pulsatile Growth Hormone (GH)-Releasing Hormone Therapy in Children With GH Deficiency*

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Abstract
We treated seven GH-deficient children with 3-hourly 1 μg/kg sc pulses of GHRH-(l–44) for 6 months and 2 μg/kg·pulse for another 6 months. Four patients had a serum GH response to iv GHRH before treatment, and an additional patient responded to iv GHRH after 1 month of pulsatile sc GHRH administration. The mean cumulative growth velocity increased from a pretreatment mean of 2.7 ± 0.2 (±se) to 8.4 ± 2.5 and 5.4 ± 0.7 cm/yr after 2 months and 1 yr of treatment, respectively. Low dose pulsatile GHRH therapy was effective inpromoting growth in five of seven children, with height gain ranging from 4.4–7.5 cm at the end of 1 yr’s therapy. Only one of the two patients who did not respond to GHRH had an improvement in linear growth when they were subsequently treated with synthetic GH. The other patient, a 16.5-yr-old pubertal girl who had both satisfactory GH and somatomedin-C responses during GHRH therapy, did not respond to either GHRH or, later, synthetic GH. The pretreatment serum GH response to iv GHRH, the serum somatomedin-C concentrations, and the peak serum GH response during sc GHRH therapy were not reliable predictors of clinical response.

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