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RESPONSE TO THERAPY IN CHILDREN WITH LOW INTEGRATED CONCENTRATION OF GROWTH HORMONE

We have previously demonstrated that the response of GH to pharmacologic stimulation does not always correspond to the actual integrated concentration of GH (ICGH)(JCEM 48:811, 1979). Spiliotis et al have reported that 3 of 7 children who had a normal response to GH provocative tests but a reduced amplitude or frequency of GH pulses, responded to GH therapy (Abstract 528 Endocr. Soc. 1983).We measured ICGH in 15 growth hormone deficient (GHD) children and in 94 children with growth impairment who exhibited a normal response to GH provocative tests (GHNR). The ICGH of the 15 GHD children ranged from 0.2 to 2.6 ng/ml. In 75 of the 94 GHNR children, the ICGH was above 2.6 ng/ml.The ICGH of the 19 remaining GHNR children was below 2.6 ng/ml. To date, 6 of these 19 children have been treated with GH for more than 5 months. All 6 responded to GH therapy (2 more than doubled their growth rate, the remaining 4 increased their growth rate by more than 2 cm/yr).Conclusion: growth impaired patients with low ICGH should be treated with GH even if they exhibit a normal response to provocative tests.