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A Treatable Cause of Short Stature

Bessie E. Spiliotis, MD; Gilbert P. August, MD; Wellington Hung, MD; William Sonis, MD; Wallace Mendelson, MD; Barry B. Bercu, MD

JAMA. 1984;251(17):2223-2230.

Abstract
Pulsatile growth hormone (GH) secretion was assessed in a subgroup of short children to determine whether they had GH secretory abnormalities, and these results were compared with those of normal and GH-deficient children. This subgroup of children was defined as having GH neurosecretory dysfunction and met the following criteria: height, less than first percentile; growth velocity, 4 cm/yr or less; bone age, two or more years behind chronological age, normal findings from provocative GH tests (peak, 10 ng/mL), low somatomedin-C level, and abnormal 24-hour GH secretory patterns. When compared with controls, both children with GH neurosecretory dysfunction and GH-deficient patients had a significant decrease in parameters relating to the total GH secretion during the 24-hour period. As with GH-deficient children, the group with GH neurosecretory dysfunction more than doubled their growth velocity after replacement therapy with exogenous human GH during the first year of treatment. As a result of these detailed studies on pulsatile GH secretion, we suggest that there is a spectrum of GH secretory abnormalities from absolute deficiency to an intermittent irregularity in GH secretion.

(JAMA 1984;251:2223-2230)

Author Affiliations
From the Pregnancy Research Branch (Drs Spiliotis and Bercu) and Child and Family Branch (Dr Sonis), National Institute of Child Health and Human Development, and the Clinical Psychology Branch, National Institute of Mental Health (Dr Mendelson), National Institutes of Health, Bethesda, Md; and the Children's Hospital National Medical Center, George Washington University, Washington, DC (Drs August and Hung).

Footnotes
Read in part before the Society for Pediatric Research, Washington, DC, May 3-6, 1983, and the Endocrine Society, San Antonio, Tex, June 8-10, 1983.

Reprint requests to College of Medicine, University of South Florida, All Children's Hospital, 801 Sixth St S, St Petersburg, FL 33701 (Dr Bercu).

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