rhGH Treatment in Corticosteroid-Treated Patients

Children and adolescents treated for chronic diseases have non-specific metabolic abnormalities that lead to decreased growth velocity and abnormal body composition, including severe osteoporosis, muscle wasting and increased fat mass. Glucocorticoid (GC) therapy plays a major role in the complex pathogenesis of these metabolic abnormalities. Recombinant human growth hormone (rhGH) therapy was introduced a few years ago to reduce the severe disease- and GC-related metabolic consequences of juvenile idiopathic arthritis, other chronic diseases, and renal transplantation. Short- and mid-term rhGH treatment has consistently proved effective in overcoming GC-induced growth suppression, with a marked interindividual variability in the growth response to rhGH treatment. Safety of rhGH treatment, concerning the progression of the disease and glucose tolerance, was good. Prolonged follow-up until achievement of adult height is needed to better evaluate the impact of rhGH treatment on growth and body composition and the long-term consequences of hyperinsulinism.