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[Knemometry in the assessment of short term effects of growth hormone therapy in children with several growth disorders].

BACKGROUND: Knemometer is a non invasive device for measuring the leg length and evaluating statural variations otherwise not disclosed by means of Harpenden stadiometer. In several clinical conditions of short stature, knemometer allows to evaluate the short-term effect of growth promoting agents, as well as the role of infections on growth dynamics. METHODS: The short-term (37-56 days) variability of the leg length in subjects with isolated growth hormone deficiency (1 case), Turner syndrome (2 cases) and Silver-Russel syndrome (1 case) treated with rhGH have been evaluated. The measurements were performed weekly by the same operator, at the same weekday and daytime. RESULTS AND CONCLUSIONS: The results show a correlation between intercurrent illnesses and growth failure, as well as a growth resumption at the end of the former, despite the etiology of short stature. Growth hormone treatment seems to exert an influence on growth only in the subject with GH deficiency, whereas a similar short term effect is not found in the cases of Turner syndrome and Silver Russel syndrome. This fact suggests that, also by knemometry, a most prolonged follow-up is required to evaluate the effect of GH on short term growth.

Adolescent↗

Pituitary stalk compression by the dorsum sellae: possible cause for late childhood onset growth disorders.

PURPOSE: The purpose of this study was to evaluate the relationship between pituitary stalk compression by the dorsum sellae and clinical or laboratory findings in short stature children. MATERIALS AND METHODS: We retrospectively reviewed magnetic resonance images of the pituitary gland and pituitary stalk for 34 short stature children with growth hormone (GH) deficiency and 24 age-matched control cases. We evaluated the degree of pituitary stalk compression caused by the dorsum sellae. Body height, GH level, pituitary height and onset age of the short stature were statistically compared between cases of pituitary stalk compression with associated stalk deformity and cases without compression. RESULTS: Compression of the pituitary stalk with associated stalk deformity was seen in nine cases within the short stature group. There were no cases observed in the control group. There were no significant differences found for body height, GH level and pituitary height between the cases of pituitary stalk compression with associated stalk deformity and cases without compression. However, a significant difference was seen in the onset age between cases with and without stalk compression. CONCLUSION: Pituitary stalk compression with stalk deformity caused by the dorsum sellae was significantly correlated with late childhood onset of short stature.

Adolescent↗

Approaches to the evaluation of growth and growth disorders in children after bone marrow transplantation (BMT).

Since impaired growth may occur as a long--term consequence in children treated with BMT this aspect of development needs particular attention for various reasons. Primarily, in each affected child parameters relevant for the evaluation of growth need to be documented regularly from the beginning in a prospective mode. In addition, treatment protocols should contain elements of a standardized follow-up for the documentation and evaluation of the endocrine, the nutritional and the emotional situation of the patient. This will eventually allow us to define--and hopefully avoid--adverse elements within complex treatment modalities--including BMT--for various malignant diseases. Thus it will be possible to develop a rational approach for the therapy of persistent adverse events following attempts of treatment primarily directed to ensure survival.

Bone Marrow Transplantation↗