[Results of early growth hormone treatment in children with hypopituitarism].

Hypopituitarism is an interesting pathological model because it allows us to examine the long-term effects of hormone replacement therapy in this population. However, the impact of growth hormone replacement therapy started before 1 year of age on final height has not been studied. The France-Hypophyse database contains the files of 59 children who started growth hormone therapy before one year of age between 1977 and 1992, and the complete growth profile of 49 patients could be analyzed Twenty girls (age at diagnosis: 6.1 +/- 3.8 months) and 29 boys (4.5 +/- 3.3 months) were treated with growth hormone for an average of 16 +/- 1.6 years. Catch-up growth was maximal during the first 3 years. At 10 years of age the patients had reached or even exceeded their target size Puberty was spontaneous (14 children) or stimulated (33 children), and occurred at an estimated bone age of 11.7 +/- 1.8 years. During puberty we observed an acceptable growth spurt but no further catch-up growth. Final height was 159 +/- 8 cm in girls and 173 +/- 7 cm in boys. No adverse effects of growth hormone therapy were reported Thanks to early GH treatment, children with hypopituitarism had a mean gap between final size and parental target size of only 0.1 +/- 1.1 SD. Early diagnosis and treatment are therefore essential in this setting.