Progression of a Structural Scoliosis During Treatment with Growth Hormone:<i>A Case Report</i>

Dymling, John‐Fredrik; Willner, Stig

doi:10.3109/17453677809005763

Cited by 32 publications

(17 citation statements)

References 3 publications

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“…As rapid growth was evident during an early period of GH therapy [Myers et al, 2000;Obata et al, 2003], this would lead to an increased risk of the development or accelerated progression of scoliosis in younger PWS patients with GH therapy [Dymling and Willner, 1978;Wang et al, 1997;Nishi et al, 1998]. However, our data showed that the frequency of scoliosis was not statistically different at any ages between patients who received GH and those without it (Table I).…”

Section: Discussioncontrasting

confidence: 54%

Growth hormone therapy and scoliosis in patients with Prader–Willi syndrome

Nagai

Obata

Ogata

et al. 2006

American J of Med Genetics Pt A

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Growth hormone (GH) therapy for short stature in patients with Prader-Willi syndrome (PWS) has started worldwide, and various favorable effects have been reported. However, the possibility of progression of scoliosis arises as a new problem of the GH therapy. In this study, we analyzed whether 72 patients who have been followed up in our hospital have such a problem. They included 46 males and 26 females (41 patients with the GH therapy and 31 without it) aged from one to 49 years. Consequently, 33 (45.8%) of 72 patients had scoliosis with the Cobb angle of >10 degrees. Twenty (48.8%) of forty-one patients who received a GH therapy and 13 (41.9%) of 31 patients without the therapy had scoliosis, the frequency of scoliosis between the two groups showing no statistical difference (P = 0.56). Height velocity of scoliotic and non-scoliotic patients during the first year of the therapy was 8.59 +/- 1.92 and 10.70 +/- 2.54 cm, respectively, showing a significant difference (P < 0.001). This shows that accelerated height velocity may not induce scoliosis. Comparison of starting age of a GH treatment revealed that non-scoliotic patients received the therapy earlier than scoliotic patients (P = 0.021). Among 20 scoliotic patients who received the GH therapy, the degree of scoliosis progressed during the therapy in six patients, improved in three and fluctuated in one. Many patients showed progression of scoliosis with age irrespective of the use of GH, and some patients improved their scoliosis during the GH therapy. These findings showed that a GH therapy increases height velocity of PWS patients but does not necessarily develop scoliosis, and early start of the therapy may not be an exacerbating factor of scoliosis.

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Section: Discussioncontrasting

confidence: 54%

Growth hormone therapy and scoliosis in patients with Prader–Willi syndrome

Nagai

Obata

Ogata

et al. 2006

American J of Med Genetics Pt A

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“…The scoliosis is progressive, in some patients even requiring surgery for stabilization of the spine 3 . Progression of scoliosis during GH therapy was reported to occur by Dymling et al 31 in one child with panhypopituitarism, although a causal relationship between progression of scoliosis and GH treatment could not be substantiated in the NCGS 32 . In our patient, a spine radiograph done at 5 years and 3 months showed an angle of 55° and a repeat one done at 5 years 9 months showed no worsening.…”

Section: Journal Of Pediatric Endocrinology and Metabolismmentioning

confidence: 94%

Robinow Syndrome with Growth Hormone Deficiency: Treatment with Growth Hormone

Castells¹,

Chakurkar²,

Qazi³

et al. 1999

Journal of Pediatric Endocrinology and Metabolism

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We describe a 5 years and nine months old boy who presented with facial features, vertebral anomalies and dwarfism consistent with Robinow syndrome. Investigations revealed growth hormone (GH) deficiency to be the cause of his dwarfism. We reviewed data on four other patients with Robinow syndrome from the Genentech National Cooperative Growth Study (NCGS). Results of GH testing on three out of four were available and showed GH deficiency. Recombinant human GH therapy in our patient and the three patients from the NCGS resulted in a significant increase in the growth rate per year. The cause of dwarfism in children with Robinow syndrome has hitherto not been studied. We propose its association with GH deficiency and that treatment with rhGH can result in a significant increase in the growth rate of these children.

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“…Serum levels of growth hormone in children with idiopathic scoliosis were found to be elevated between the ages of seven and twelve years compared to controls [3-7]. Progression of structural scoliosis was reported in a short-statured patient during Human Growth Hormone (HGH) treatment [8] and stimulated a systematic clinical audit of children with scoliosis on an HGH treatment programme in one institution [9]. The administration of HGH appeared to accelerate the progression of scoliosis in six of ten children on that programme (cohort size 250) [9].…”

Section: Introductionmentioning

confidence: 99%