INTRODUCTION. Short stature is one of the major, nonspecific features of juvenile idiopathic arthritis (JIA), that affects, in dependence on clinical presentation and severity, 11-90% of patients. The treatment with human recombinant growth hormone (rhGH) may be successful in almost 70% of such cases. the aim of the study was to analyze the initial results of the rhGH treatment in children with severe growth failure and GH deficiency secondary to JIA.
MATERIAL AND METHODS. From among 10 children (4 boys, 6 girls), age 6-15.5, mean 12.2 years, with growth deficiency [(-)7.7-(-2.4) the SDS], 5 (2 boys, 3 girls) with coexisting GH deficiency received rhGH treatment. All patients were treated with glucocorticoids (GCS) with a mean dosage of 0.08-1.4 mg/kg/day (prednisone), 3 of the patients treated with rhGH, and all non-treated patients received biological treatment (Etanercept).
RESULTS. After one year of rhGH treatment with a dosage of 0.03-0.06, mean 0.047 mg/kg/day) the growth velocity increased from 0–3.2, mean 1 cm/year, to 0.3-16, mean 3.3 cm/year, as well as the insulin like growth factor type 1 concentration from 69.1-331.1 (mean 197.5) ng/ml to 335-716,9 (mean 526) ng/ml. In 16.6 patient-years of treatment (5 patients, individual treatment period 1.8-4.5; mean 3.8 years) there was improvement of growth from 0.1 to 2.2 SD in 4 cases.
CONCLUSIONS. In patients with JIA undergoing rhGH treatment, with a dosage of approximately 0.047 mg/kg/day, improves growth velocity, and final height. The results may be different in individual cases. They are better if the growth failure before treatment is less severe, and the inflammation process is less active.
Endocrinology, Obesity and Metabolic Disorders 2010, vol. 6, No 2, 67-71