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New indications for growth hormone
  1. Nicola Bridges
  1. For correspondence:
    Dr Nicola A Bridges
    Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK;

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Many members of the public have heard about growth hormone (GH), and paediatric endocrinologists regularly find themselves explaining the limitations of GH therapy to families who have come looking for something to increase their child’s height. GH was originally extracted from human pituitaries to treat children with GH deficiency. The introduction of recombinant GH in 1985 increased the supply of GH and trials were initiated in short stature conditions not associated with GH deficiency. The results of these trials have extended the range of conditions treated with growth hormone (table 1).

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Table 1

 The use of growth hormone (GH) therapy in short stature


Turner syndrome

Turner syndrome is associated with short stature which is not explained by GH deficiency. Trials of GH treatment have demonstrated improved final height, but there is variation in the increment in final height reported, from no gain at all to 16 cm.2 One of the difficulties in interpreting the data available is that there are few studies with an untreated control group. Most rely on comparison with height predictions or historical control groups. A mean untreated adult height of 143 cm was reported 1985,3 but as in the general population, there has probably been a secular trend in the height of Turner women.2 There have been two randomised controlled studies of GH treatment in Turner syndrome, reporting mean final heights of 142.9 cm and 147.3 cm, and 141.4 cm and 146.2 cm in untreated and treated groups, respectively.4,5 A girl treated with GH using current standard treatment can expect an increase of approximately 6 cm in adult height.6,7 Earlier start of GH treatment and higher GH dose may increase this, although this is also likely to increase the cost per centimetre gained—currently about £17 000 per cm.8 Adult women with Turner …

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  • Competing interests: The author has been reimbursed for attending several meetings by Pharmacia and Upjohn (now Pfizer) and attended meetings supported financially by Ipsen.