Growth hormone deficiency (GHD) in children results in impaired growth velocity and a failure to attain normal adult height appropriate for genetic potential. An evidence-based, individualized treatment approach — with structured monitoring of biochemical response — is the foundation of management.

Clinical Goals

Acceleration of growth velocity and normalization of growth and stature during childhood
Attainment of normal adult height appropriate for the child's genetic potential
Serum IGF-I level maintained within the normal range for age and pubertal stage

Treatment Approach

Management centres on recombinant human growth hormone therapy, with dosing individualized to each child and adjusted according to biochemical response.

Full dosing strategy, monitoring criteria, adjustment thresholds, and continuation rules are available in the structured protocol →

References

DOI: 10.1159/000452150

The primary objectives of GH treatment for patients with GHD are acceleration of growth velocity to promote normalization of growth and stature during childhood and attainment of normal AH appropriate for the child's genetic potential.
We recommend the use of weight-based or body surface area (BSA)-based GH dosing in children with GHD.
We recommend an initial GH dose of 0.16–0.24 mg/kg/week (22–35 μg/kg/day) with individualization of subsequent dosing.
Some patients may require higher doses.
We suggest that the GH dose be lowered if serum IGF-I levels rise above the laboratory-defined normal range for the age or pubertal stage of the patient.
We recommend that GH treatment at pediatric doses not continue beyond attainment of a growth velocity below 2–2.5 cm/year.

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Treatment of Growth Hormone Deficiency in Children

Clinical Goals

Treatment Approach

References