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Biomedical subjects

E Mugnier

Publications and source records attributed to E Mugnier.

9 recordsLinked to original sources
PubMed1992

Effect of growth hormone on the low level of growth hormone binding protein in idiopathic short stature.

OBJECTIVE: Growth hormone receptor status was assessed in children with idiopathic short stature by evaluating plasma growth hormone-binding protein before and under GH therapy. DESIGN: Among 22 children presenting idiopathic short stature, 15 were randomly selected to be treated with GH (1.2 IU/kg/week); they were studied before and under GH therapy. Untreated patients served as a control group for age and GH effect. PATIENTS: Twenty-two prepubertal children, aged 5-11 years, were studied. They presented growth retardation of -2.8 +/- 0.1 SDS (mean +/- SEM). All had normal GH secretion and their mean IGF-I plasma level was normal. MEASUREMENT: Growth hormone-binding protein was measured using high pressure liquid chromatography gel filtration. The specific binding of 125I-hGH to the growth hormone-binding protein was expressed as a percentage of the total radioactivity. RESULTS: Specific binding of 125I-hGH to the high affinity growth hormone-binding protein was low with a mean +/- SEM value of 11.1 +/- 0.9% of radioactivity. In the treated group, growth hormone-binding protein increased significantly after 3 months of treatment; it reached 21.1 +/- 1.0% of radioactivity (mean +/- SEM) in the eight children who have been treated for 18 months. In the seven untreated children, the growth hormone-binding protein value increased to 16.2 +/- 1.1% after 18 months; this value is significantly lower than that found in the GH-treated children, demonstrating that the GH effect is greater than the age-related increase in the growth hormone-binding protein. A positive correlation was found between IGF-I plasma levels and growth hormone-binding protein and also between growth velocity and growth hormone-binding protein. CONCLUSIONS: The low growth hormone-binding protein and the response to high doses of GH suggest partial GH resistance at the receptor level, in this group of children with idiopathic short stature.

Carrier Proteins↗
PubMed1989

Long term feasibility of multiple daily injections with insulin pens in children and adolescents with diabetes.

During a period of 17 months, 15 C-peptide negative insulin-dependent diabetic children (14 +/- 4 years old) have used an injector pen (Novopen, Novo, France) to deliver soluble insulin before meals, in association with an insulin syringe for long-acting insulin administration at bedtime. Despite frequent daily insulin injections (4-5) and blood glucose determinations (3-4), long-term patient acceptability as well as cutaneous tolerance were excellent. Novopen was experienced as a progress (100%) which made a multiple injection regimen acceptable and provided an improvement in the quality of life (77%), as recorded by questionnaires answered at the end of the study. Twelve out of 15 patients chose to continue this treatment. No significant change in glycaemic control was observed in the group as a whole. An improvement in glycosylated haemoglobin (HbA 1c) was noticed only in the previously "poorly-controlled" children (n = 8) with initial HbA1c greater than 7%. In this group HbA1c decreased from 8.4 +/- 1.8% (mean +/- SD), to 7.3 +/- 1.2% (P less than 0.05) within the first 6 months of Novopen therapy. No increment of hypoglycaemia frequency and mean daily insulin requirements was observed. No ketoacidotic episode was noticed during the study. In conclusion, in this group of diabetic children, no long term metabolic improvement was obtained, despite excellent acceptability of the multiple injection regimen with Novopen.

Adolescent↗
PubMed1988

Human pituitary growth hormone (hGH) and Creutzfeldt-Jakob disease: results of an epidemiological survey in France, 1986.

An epidemiological inquiry has been done in France after the notification in the USA and England of four cases of Creutzfeldt-Jakob disease in patients previously treated with hGH. Between 1959, when hGH treatment in France was started, and August 1985, the date the survey began, 1698 patients were registered for treatment. Current information (less than three months old) was obtained for 1620 patients (95.4%). Death was reported in 31 patients, but none could be related to Creutzfeldt-Jakob or similar disease. Pathological events were observed in 213 living patients (13.1%). Among them, four were diseases classified as possibly related to a viral infection. The first case had acute lymphoid leukaemia; the second case had polyradiculoneuritis associated with hepatitis. In both cases the disease resolved completely. Two other patients had acute encephalitis which started less than two years after the onset of treatment and which resolved spontaneously. Even though the acute evolution and the spontaneous clinical recovery are not consistent with Creutzfeldt-Jakob disease, a relationship with hGH therapy could not be completely excluded. Finally, five treated children had later malignancies which raises the question of the long-term secondary effects of hGH upon cellular proliferation.

Adolescent↗
PubMed1988

[Treatment with growth hormone: results and new perspectives].

The use of human growth hormone is being extensively reevaluated in children with hypopituitarism, as we enter a new phase with sufficient supply of recombinant hGH. Simultaneously much emphasis has been placed on the methods of measurement of GH secretion in order to define a more appropriate cutoff level defining partial GH deficiency. Among non conventional indications of hGH, Turner syndrome has turned out to be most important with very encouraging short term results. The extension of hGH therapy to other clinical groups, as non endocrine short stature is still under careful investigation in many groups. A long term follow-up is necessary to assess the true benefit of such a treatment and the absence of metabolic and immunological side effects. We should keep a critical attitude toward the very likely extension of the use of hGH considering that many areas, principally in adults, remain to be explored.

Growth Disorders↗
PubMed1986

[Hypoglycemia].

Explore the source record for details and available documents.

Blood Glucose↗
PubMed1985

[Results of treatment with human growth hormone in children with pituitary insufficiency under 7 years of age. Study of 26 cases].

Twenty-six children below age 7 years with idiopathic growth hormone deficiency have been treated with hGH for 2 years. Bone ages were inferior to 3 years and growth retardation averaged 3.9 +/- 0.9 standard deviation (SD) below the population mean. Results were compared to those obtained in a control group of 29 prepubertal patients, aged more than 7 years, and treated with hGH according to the same protocol. The mean height gains during the first and second year of treatment were respectively 8.4 +/- 1.8 cm and 6.6 +/- 1.5 cm. These values are significantly higher than those obtained in the group of older children. However within 2 years of treatment the initial catch-up in height of 0.9 +/- 0.6 DS was not different. In conclusion, we did not observe a better catch up growth in children before 7 years of age than in older prepubertal children, in spite of using higher doses of hGH.

Age Factors↗
PubMedDate not supplied

[Evaluation of risks related to human growth hormone (hGH) treatment. Results of an epidemiologic survey conducted in France of patients treated from 1959 to 1985].

Following the notification in the USA and England of four cases of Creutzfeldt-Jacob disease (MCJ) in patients previously treated with hGH, an epidemiological inquiry has been done in France to set up a clinical evaluation of all patients treated from 1959 to 1985. 1698 patients were registered for treatment. Current information (less than three months old) was obtained for 1622 patients (95.5%). Death was reported in 32 patients (2.0%), one is possibly related to a viral infection (malignant lymphoma), but none could be related to MCJ. Accidents were observed in 213 living patients (13.1%). Among them, 4 cases were classified as possibly related to a viral infection: acute lymphoid leukaemia, polyradiculoneuritis associated with hepatitis, acute encephalitis (2 cases). Even though the clinical symptomatology is not consistent with MCJ, a relationship with hGH therapy could not be completely excluded. Finally, six patients undertreatment developed malignancies. During the three last years, the question of side effects of hGH therapy has been raised in the literature two times running: risk of MCJ and risk of leukaemia. Then, the question of the long term vigilance of all treated patients with hGH deficiency should be done.

Creutzfeldt-Jakob Syndrome↗
PubMedDate not supplied

[Treatment with hGH. Factors influencing response in children with somatotrophic insufficiency (author's transl)].

The present study was designated to investigate causes of hGH treatment failure in 59 prepubertal children, with idiopathic or organic GH deficiency. Children with height gain of less than 6 cm during the first year of treatment were the oldest, those with tallest stature, and had a lower growth rate prior to treatment. Increase of growth rate was negatively correlated with pre-treatment growth rate. Poor results were chiefly observed in children with tumoral organic hypopituitarism or after irradiation of the brain. Finally hGH doses appeared to be similar when two groups with respectively poor and good results were compared, indicating a major role of endogenous factors.

Age Factors↗