This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints, Permissions and Rights Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lebrethon, M.-C. Articles by Savage, M. O. Search for Related Content PubMed PubMed Citation Articles by Lebrethon, M.-C. Articles by Savage, M. O.

Linear Growth and Final Height after Treatment for Cushing’s Disease in Childhood

Pediatric Endocrinology Section (M.C.L., M.O.S.), Departments of Endocrinology (A.B.G., G.M.B.), Neurosurgery (F.A.), and Radiotherapy (P.N.P.), St. Bartholomew’s Hospital, London, United Kingdom EC1A 7BE

Address all correspondence and requests for reprints to: Prof. Martin O. Savage, Pediatric Endocrinology Section, Department of Endocrinology, St. Bartholomew’s Hospital, West Smithfield, London, United Kingdom EC1A 7BE. E-mail: m.o.savage{at}mds.qmw.ac.uk

Cushing’s disease is associated with growth failure in childhood and adolescence. Growth and final height were analyzed in 10 patients who were cured or in remission after treatment of Cushing’s disease. Seven males and 3 females, aged 6.8–17.6 yr (bone age, 3.3- 15.4 yr), had transsphenoidal surgery, which was combined with pituitary irradiation (4500 cGy in 25 fractions) in 5 patients. At presentation, 5 patients were prepubertal (males), and 5 were pubertal (2 males and 3 females). The mean height SD score was -2.15 ± 1.26 (range, -0.21 to -4.32) compared with mean target height SD score of -0.43 ± 0.58. Height velocity in 6 patients was subnormal (0.9–3.8 cm/yr). After treatment, short-term height velocity, over a mean interval of 0.57 yr, in 8 patients not receiving human GH (hGH) therapy, was variable (range, 0.8–7.6 cm/yr). GH stimulation tests (insulin tolerance test/glucagon) in 9 subjects showed peak GH levels of 0.5–20.9 mU/L. Eight were treated with hGH (14 IU/m²·wk), combined in 2 girls and 1 boy with a GnRH analog. After 1 yr of hGH, the mean height SD score had increased from -2.45 ± 1.0 at initiation of hGH to -2.07 ± 1.2 (P = 0.01). GH therapy was continued until final height or latest assessment. The mean final height SD score (n = 6) was -1.24 ± 1.38, and at the latest assessment the mean height SD score (n = 4) was -1.52 ± 1.33. Combining these 2 groups, the mean height SD score was -1.36 ± 1.29. The difference between final or latest height SD score and target height SD score was 0.93 ± 1.13, i.e. less (P = 0.005) than the difference between height and target height SD score of 1.72 ± 1.26 at presentation. In conclusion, catch-up and favorable long-term growth was seen after treatment for Cushing’s disease. Posttreatment GH deficiency was frequent, and early hGH replacement may have contributed to the encouraging outcome.

This article has been cited by other articles:

				D. L. Batista, J. Riar, M. Keil, and C. A. Stratakis Diagnostic Tests for Children Who Are Referred for the Investigation of Cushing Syndrome Pediatrics, September 1, 2007; 120(3): e575 - e586. [Abstract] [Full Text] [PDF]

				L F Chan, H L Storr, P N Plowman, L A Perry, G M Besser, A B Grossman, and M O Savage Long-term anterior pituitary function in patients with paediatric Cushing's disease treated with pituitary radiotherapy Eur. J. Endocrinol., April 1, 2007; 156(4): 477 - 482. [Abstract] [Full Text] [PDF]

				F. Pecori Giraldi, M. Andrioli, L. De Marinis, A. Bianchi, A. Giampietro, M. De Martin, E. Sacco, M. Scacchi, A. Pontecorvi, and F. Cavagnini Significant GH deficiency after long-term cure by surgery in adult patients with Cushing's disease Eur. J. Endocrinol., February 1, 2007; 156(2): 233 - 239. [Abstract] [Full Text] [PDF]

				J. W. Findling and H. Raff Cushing's Syndrome: Important Issues in Diagnosis and Management J. Clin. Endocrinol. Metab., October 1, 2006; 91(10): 3746 - 3753. [Abstract] [Full Text] [PDF]

				G. Arnaldi, A. Angeli, A. B. Atkinson, X. Bertagna, F. Cavagnini, G. P. Chrousos, G. A. Fava, J. W. Findling, R. C. Gaillard, A. B. Grossman, et al. Diagnosis and Complications of Cushing's Syndrome: A Consensus Statement J. Clin. Endocrinol. Metab., December 1, 2003; 88(12): 5593 - 5602. [Abstract] [Full Text] [PDF]

				H. L. Storr, P. N. Plowman, P. V. Carroll, I. Francois, G. E. Krassas, F. Afshar, G. M. Besser, A. B. Grossman, and M. O. Savage Clinical and Endocrine Responses to Pituitary Radiotherapy in Pediatric Cushing's Disease: An Effective Second-Line Treatment J. Clin. Endocrinol. Metab., January 1, 2003; 88(1): 34 - 37. [Abstract] [Full Text] [PDF]