Arch Dis Child 1999;80:221-225 ( March )

A decade of growth hormone treatment in girls with Turner syndrome in the UK

P R Betts,^a G E Butler,^b M D C Donaldson,^c D B Dunger,^d D I Johnston,^e C J H Kelnar,^f J Kirk,^g D A Price,^h P Wilton,ⁱ the UK KIGS Executive Group on behalf of the participating centres

^a Southampton General Hospital, Southampton, UK, ^b Department of Paediatric and Adolescent Endocrinology, Leeds General Infirmary, Leeds, UK, ^c Department of Child Health, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK, ^d Department of Paediatrics, John Radcliffe Hospital, Headington, UK, ^e Children's Department, University Hospital, Queen's Medical Centre, Nottingham, UK, ^f Royal Hospital for Sick Children, Edinburgh, UK, ^g The Birmingham Children's Hospital, Ladywood Middleway, Birmingham, UK, ^h Royal Manchester Children's Hospital, Pendlebury, Manchester, UK, ⁱ Pharmacia and Upjohn, Stockholm, Sweden

Correspondence to: Dr P R Betts, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.

Accepted 8 October 1998

Fifteen per cent of children treated with growth hormone (GH) are receiving treatment for Turner syndrome, but few results are available on final height in the UK. In this study, data were obtained from the UK KIGS database for 485 girls with Turner syndrome who were treated from 1986, allowing an audit of practice and outcome over 10 years. Over the decade, the mean age of starting growth hormone treatment fell from 10.4 to 8.5 years and the starting dose increased from 0.55 to 0.95 IU/kg/week. The frequency of injections increased from three to six or seven/week. Some girls received suboptimal doses, which also differed depending on whether they were based on weight or surface area. To assess what height gain might be expected at final height, all 52 girls who were prepubertal at the start of treatment, which continued for four years or more, and who had reached final height or had a growth velocity < 2 cm/year were selected. Their mean gain in final height was 5.2 cm and the GH dose was 0.78 IU/kg/week over 5.8 years. Final height gain correlated significantly with duration of treatment, total dose received, and first year response, which itself related to starting dose. This audit shows a changing pattern of treatment over the past decade, which in many instances has been inadequate. When treatment starts before puberty and continues through to final height, with a dose of 30 IU/m²/week in six or seven injections, a mean increase in final height of 5 cm or more would be expected.

Keywords: growth hormone; Turner syndrome; height gain

---

© 1999 by Archives of Disease in Childhood
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Donaldson, M D C, Gault, E J, Tan, K W, Dunger, D B (2006). Optimising management in Turner syndrome: from infancy to adult transfer. Arch. Dis. Child. 91: 513-520 [Abstract] [Full Text]  
• Sybert, V. P., McCauley, E. (2004). Turner's Syndrome. NEJM 351: 1227-1238 [Full Text]  
• (2002). Why give a child growth hormone?. DTB 40: 17-20 [Abstract] [Full Text]  
• Elsheikh, M., Dunger, D. B., Conway, G. S., Wass, J. A. H. (2002). Turner's Syndrome in Adulthood. Endocr. Rev. 23: 120-140 [Abstract] [Full Text]  
• Ogata, T., Muroya, K., Matsuo, N., Shinohara, O., Yorifuji, T., Nishi, Y., Hasegawa, Y., Horikawa, R., Tachibana, K. (2001). Turner Syndrome and Xp Deletions: Clinical and Molecular Studies in 47 Patients. J. Clin. Endocrinol. Metab. 86: 5498-5508 [Abstract] [Full Text]  
• Kirk, J M W, Betts, P R, Butler, G E, Donaldson, M D C, Dunger, D B, Johnston, D I, Kelnar, C J H, Price, D A, Wilton, P, Group, t. U. K. E. (2001). Short stature in Noonan syndrome: response to growth hormone therapy. Arch. Dis. Child. 84: 440-443 [Abstract] [Full Text]  
• Ogata, T., Matsuo, N., Nishimura, G. (2001). SHOX haploinsufficiency and overdosage: impact of gonadal function status. J. Med. Genet. 38: 1-6 [Abstract] [Full Text]  
• Johnston, D I, Betts, P, Dunger, D, Barnes, N, Swift, P G F, Buckler, J M H, Butler, G E (2001). A multicentre trial of recombinant growth hormone and low dose oestrogen in Turner syndrome: near final height analysis. Arch. Dis. Child. 84: 76-81 [Abstract] [Full Text]  
• Binder, G., Schwarze, C. P., Ranke, M. B. (2000). Identification of Short Stature Caused by SHOX Defects and Therapeutic Effect of Recombinant Human Growth Hormone. J. Clin. Endocrinol. Metab. 85: 245-249 [Abstract] [Full Text]  
• Guyda, H. (1999). Four Decades of Growth Hormone Therapy for Short Children: What Have We Achieved?. J. Clin. Endocrinol. Metab. 84: 4307-4316 [Full Text]