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Article: Consensus Statement on the Diagnosis and Treatment of Children with Idiopathic Short Stature: A Summary of the Growth Hormone Research Society, the Lawson Wilkins Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology Workshop

TitleConsensus Statement on the Diagnosis and Treatment of Children with Idiopathic Short Stature: A Summary of the Growth Hormone Research Society, the Lawson Wilkins Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology Workshop
Authors
Issue Date2008
PublisherThe Endocrine Society. The Journal's web site is located at http://jcem.endojournals.org
Citation
Fulltext link: http://press.endocrine.org/doi/pdf/10.1210/jc.2008-0509; L low is one of the member of 2007 ISS Consensus Workshop participants How to Cite?
AbstractOBJECTIVE: Our objective was to summarize important advances in the management of children with idiopathic short stature (ISS). PARTICIPANTS: Participants were 32 invited leaders in the field. EVIDENCE: Evidence was obtained by extensive literature review and from clinical experience. CONSENSUS: Participants reviewed discussion summaries, voted, and reached a majority decision on each document section. CONCLUSIONS: ISS is defined auxologically by a height below -2 sd score (SDS) without findings of disease as evident by a complete evaluation by a pediatric endocrinologist including stimulated GH levels. Magnetic resonance imaging is not necessary in patients with ISS. ISS may be a risk factor for psychosocial problems, but true psychopathology is rare. In the United States and seven other countries, the regulatory authorities approved GH treatment (at doses up to 53 microg/kg.d) for children shorter than -2.25 SDS, whereas in other countries, lower cutoffs are proposed. Aromatase inhibition increases predicted adult height in males with ISS, but adult-height data are not available. Psychological counseling is worthwhile to consider instead of or as an adjunct to hormone treatment. The predicted height may be inaccurate and is not an absolute criterion for GH treatment decisions. The shorter the child, the more consideration should be given to GH. Successful first-year response to GH treatment includes an increase in height SDS of more than 0.3-0.5. The mean increase in adult height in children with ISS attributable to GH therapy (average duration of 4-7 yr) is 3.5-7.5 cm. Responses are highly variable. IGF-I levels may be helpful in assessing compliance and GH sensitivity; levels that are consistently elevated (>2.5 SDS) should prompt consideration of GH dose reduction. GH therapy for children with ISS has a similar safety profile to other GH indications.
Persistent Identifierhttp://hdl.handle.net/10722/80102
ISSN
2015 Impact Factor: 5.531
2015 SCImago Journal Rankings: 2.940
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorCohen, Pen_HK
dc.contributor.authorRogol, ADen_HK
dc.contributor.authorDeal, CLen_HK
dc.contributor.authorSaenger, Pen_HK
dc.contributor.authorReiter, EOen_HK
dc.contributor.authorRoss, JLen_HK
dc.contributor.authorChernausek, SDen_HK
dc.contributor.authorSavage, MOen_HK
dc.contributor.authorWit, JMen_HK
dc.contributor.author2007 ISS Consensus Workshop participantsen_HK
dc.contributor.authorLow, L-
dc.date.accessioned2010-09-06T08:02:26Z-
dc.date.available2010-09-06T08:02:26Z-
dc.date.issued2008en_HK
dc.identifier.citationFulltext link: http://press.endocrine.org/doi/pdf/10.1210/jc.2008-0509; L low is one of the member of 2007 ISS Consensus Workshop participantsen_HK
dc.identifier.issn0021-972X-
dc.identifier.urihttp://hdl.handle.net/10722/80102-
dc.description.abstractOBJECTIVE: Our objective was to summarize important advances in the management of children with idiopathic short stature (ISS). PARTICIPANTS: Participants were 32 invited leaders in the field. EVIDENCE: Evidence was obtained by extensive literature review and from clinical experience. CONSENSUS: Participants reviewed discussion summaries, voted, and reached a majority decision on each document section. CONCLUSIONS: ISS is defined auxologically by a height below -2 sd score (SDS) without findings of disease as evident by a complete evaluation by a pediatric endocrinologist including stimulated GH levels. Magnetic resonance imaging is not necessary in patients with ISS. ISS may be a risk factor for psychosocial problems, but true psychopathology is rare. In the United States and seven other countries, the regulatory authorities approved GH treatment (at doses up to 53 microg/kg.d) for children shorter than -2.25 SDS, whereas in other countries, lower cutoffs are proposed. Aromatase inhibition increases predicted adult height in males with ISS, but adult-height data are not available. Psychological counseling is worthwhile to consider instead of or as an adjunct to hormone treatment. The predicted height may be inaccurate and is not an absolute criterion for GH treatment decisions. The shorter the child, the more consideration should be given to GH. Successful first-year response to GH treatment includes an increase in height SDS of more than 0.3-0.5. The mean increase in adult height in children with ISS attributable to GH therapy (average duration of 4-7 yr) is 3.5-7.5 cm. Responses are highly variable. IGF-I levels may be helpful in assessing compliance and GH sensitivity; levels that are consistently elevated (>2.5 SDS) should prompt consideration of GH dose reduction. GH therapy for children with ISS has a similar safety profile to other GH indications.-
dc.languageengen_HK
dc.publisherThe Endocrine Society. The Journal's web site is located at http://jcem.endojournals.org-
dc.relation.ispartofJournal of Clinical Endocrinology and Metabolismen_HK
dc.subject.meshBody Height-
dc.subject.meshEndocrinology - methods-
dc.subject.meshGonadotropin-Releasing Hormone - therapeutic use-
dc.subject.meshGrowth Disorders - classification - diagnosis - psychology - therapy-
dc.subject.meshInsulin-Like Growth Factor I - deficiency-
dc.titleConsensus Statement on the Diagnosis and Treatment of Children with Idiopathic Short Stature: A Summary of the Growth Hormone Research Society, the Lawson Wilkins Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology Workshopen_HK
dc.typeArticleen_HK
dc.identifier.emailLow, L: lcklow@hkucc.hku.hken_HK
dc.identifier.authorityLow, LCK=rp00337en_HK
dc.identifier.doi10.1210/jc.2008-0509-
dc.identifier.pmid18782877-
dc.identifier.hkuros162661en_HK
dc.identifier.volume93-
dc.identifier.issue11-
dc.identifier.spage4210-
dc.identifier.epage4217-
dc.identifier.isiWOS:000260661900005-
dc.publisher.placeUnited States-

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