Response to growth hormone therapy in patients with growth hormone deficiency who at birth were small or appropriate in size for gestational age.

Objective: To determine long-term growth response to growth hormone (GH) therapy in patients with isolated GH deficiency who had been small for gestational age and in those who had been appropriate in size for gestational age.

Design: Longitudinal, case-control study.

Setting: Pediatric clinic, endocrinology center, University of Bologna, Italy.

Value and limits of pharmacological and physiological tests to diagnose growth hormone (GH) deficiency and predict therapy response: first and second retesting during replacement therapy of patients defined as GH deficient.

There is currently a debate about the use of pharmacological and physiological tests to define GH deficiency and predict response to GH therapy. In addition, a good response to therapy has also been described in subjects without GH deficiency. For further information, we reevaluated GH secretion during replacement therapy in a group of children defined as GH deficient and examined response to therapy in the subjects subdivided according to secretion.

Pitfalls in diagnosing impaired growth hormone (GH) secretion: retesting after replacement therapy of 63 patients defined as GH deficient.

Possible causes of error in the diagnosis of isolated GH deficiency are the variability of GH response to repeated tests, the existence of transient GH deficiencies, and the low GH levels found in short statured children with delayed puberty. Sixty-three patients with variously expressed GH deficiency were retested (1 sleep test and 2 pharmacological tests) after 1-3.9 yr of GH therapy (dose, 15 U/m2.

[Auxological data and definitive height in short patients without hormonal deficiencies. A longitudinal study].

61 children (49 males and 12 females) with stature before puberty less than 3. centile were studied. They had been previously diagnosed with the various GH stimulation tests as "constitutional short" and they were measured after reaching final adult height.

Variability of growth hormone response to pharmacological and sleep tests performed twice in short children.

Forty-nine children with short stature (age range, 4.1-15.9 yr) were examined.

Growth hormone evaluation in Duchenne muscular dystrophy.

Growth hormone (GH) release with pharmacological tests and sleep test, somatomedin C and auxological features were studied in 10 patients affected by Duchenne Muscular Dystrophy. GH release in these patients seems to be lower than normal; moreover some of them are of short stature without an evident relationship with GH deficit. The possible significance of the data obtained is discussed, particularly in relation to the clinical course of the disease, and to current therapeutic trials with a GH release inhibitor (mazindol).

Haemorheologic and fibrinolytic evaluation in obese children and adolescents.

The haemorheologic condition was evaluated in 43 obese children and 35 controls. In 18 of the obese children and in 21 controls the euglobulin lysis time (ELT) was also studied. Blood viscosity at 94.

Growth and growth factors in diabetes mellitus.

Growth of 79 children with diabetes was analysed at diagnosis and again after one to 10.7 years of treatment with insulin. Both sexes were tall at onset, whereas at the last observation boys alone showed significant growth retardation.

Differences in somatomedin-C between short-normal subjects and those of normal height.

We evaluated basal somatomedin-C (SmC) levels in 98 subjects 2 to 16.6 years of age, with height less than 3rd centile (Tanner), and in 274 healthy controls 2 to 15.8 years, with height greater than 10th centile.

Pelvic ultrasonography in premenarcheal girls: relation to puberty and sex hormone concentrations.

Real time ultrasonography of the pelvic organs was performed on 114 normal premenarcheal girls aged between 2 years and 13 years 11 months. Values were obtained for total uterine length, anteroposterior diameters of the corpus and cervix, corpus/cervix ratio, and uterine and ovarian volumes and the resultant data were grouped according to age. It was concluded that there is no change in uterine size until approximately 7 years of age.

Thyroid function and prolactin levels in insulin-dependent diabetic children and adolescents.

We evaluated serum thyroid hormones, TSH, and prolactin before and after induction of TRH and thyroid microsomal autoantibodies in 91 diabetic children and adolescents (mean age 11.11 +/- 4.13 yr), with illness ranging from a few days to 14.

Short stature and celiac disease: a relationship to consider even in patients with no gastrointestinal tract symptoms.

To determine the incidence of celiac disease in a group of nonselected children with short stature, duodenal biopsy was performed in 60 unselected children with short stature (below third centile) and absence of gastrointestinal tract symptoms. Examination revealed probable celiac disease in five children (8.3%).

Effect of obesity on the hypothalamo-pituitary-gonadal function in childhood.

In 22 normal and 35 obese boys a gonadal function test (2000 IU of hCG i.m. daily for three days and assays of plasma testosterone before and after the hCG administration) was carried out.

Congenital hypopituitarism associated with neonatal hypoglycemia and microphallus: effect of GH therapy.

A case of congenital hypopituitarism with microphallus and severe neonatal hypoglycemia is described. The results of the clinical examination and of the tests of hypothalamo-pituitary function are discussed. It is reported that with GH replacement therapy a considerable growth of the penile size was obtained.

GH, ACTH, TSH, LH, and FSH reserve in pre pubertal girls with congenital adrenal hyperplasia.

The pituitary reserve of GH, ACTH, TSH, LH, and FSH was determined in seven prepubertal birls suffering from congenital adrenal hyperplasia due to 21-hydroxylation defect and under treatment with cortisone acetate. GH and ACTH were studied during the insulin induced hypoglycemia test. The LH, FSH, and TSH reserved were assayed by means of the LH-RH and TRH tests.

Hypophyso-gonadal function in the cryptorchid child: differences between unilateral and bilateral cryptorchids.

In 22 normal boys, 33 unilateral and 14 bilateral cryptorchids, a gonadal function test (2000 IU of HCG im each day for three days and assays of plasma testosterone and plasma oestradiol-17beta before and after the HCG administration) as well as an LH-RH test were carried out. In 60% of the cases, both normal and cryptorchid boys, plasma oestradiol-17beta (both in basal conditions and after stimulus) were found to be less than the sensitivity (5 pg/ml) of the method, While the plasma testosterone was similar under basal conditions in the three groups of children, after HCG it was significantly lower than the mean value of the control group only in the bilateral cryptorchids. The testosterone levels, both under basal conditions and after stimulus, are correlated to bone age only in the normal boys and in the unilateral cryptorchids.