著者

Chatelain Pierre G. Claris Olivier Nicolino Marc

出版者

日本小児内分泌学会

雑誌

Clinical Pediatric Endocrinology

巻号頁・発行日

vol.3, no.5, pp.27-34, 1994

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Intra-uterine growth retardation (IUGR) and Silver-Russell syndrome (SRS) are born short for gestational age and many of them do not show post-natal catch-up growth Although post-natal catch-up growth frequently occurs, significant number of both IUGR and SRS newborns often fail to catch up. This may result in very short adult height (more than 2 standard deviations (SD) below the mean) in up to 20% of these patients, in association with poor school and social performance.<BR>In order to try to induce catch-up growth and hopefully increase final height, attempts have been made in clinical trial to treat these growth hormone (GH) sufficient patients with human GH.<BR>Using the Kabi Pharmacia International Growth Study patient data base, a group of 106 IUGR (83 males and 23 females) and 45 SRS with persistent post-natal growth failure were studied. IUGR clinical characteristics included a birth length and weight more than 2 SD below the mean for gestational age. Height deficit at start of the GH treatment was -3.0 standard deviation scores (SDS) for chronological age (CA), at a median CA of 8.7 years with a median bone age (BA) of 7.0 years. Mean parental heights were 166 cm for fathers and 153 cm for mothers. Median dose of recombinant human GH (rhGH) in 106 IUGR patients was 0.5 IU/kg/week, given at a median frequency of 5 injections per week. The median height SDS for CA at the start and at 1, 2 and 3 years of hGH treatment were -3.0, -2.5, -2.1 and -1.9 respectively.<BR>45 patients presented with SRS. Their median CA and BA at start of treatment were 6.7 and 3.2 years respectively. Mean parental heights were 167.5 cm for fathers and 160 for mothers. Median dose of rhGH in these 45 SRS was 0.7 IU/kg/week, with a median frequency of 6 injections per week. Median height SDS of SRS patients at start, 1, 2 and 3 years of hGH treatment were -3.5, -2.9, -2.8 and -2.2 respectively. One difference between these IUGR and SRS groups is that SRS patients tended to be born of normal height parents, in contrast to IUGR with persistent post-natal growth failure. In these two groups, exogenous GH treatment tended to induce catch up growth, although long term follow up is sufficient to allow conclusions to be draw regarding these patients' final adult height.