Treatment of children with Turner’s syndrome with recombinant growth hormone

Objective ? improvement of method and strategy in the treatment of children with TS. Materials and methods. In order to evaluate the effectiveness of treatment with rGH in girls with TS we analyzed a database of children with growth retardation, our own observations in 135 patients with TS and the results of treatment. The effectiveness of treatment was analyzed in patients with different karyotypes, which were divided into two groups ? prepubertal(up to 12 years (n=65) and pubertal age group(over 12 years (n=70)). We studied the growth rate (cm, SD) before and during treatment with rGH. Somatotropin function was investigated in 98 girls with TS - blood level of IGF-1 was determined and standard clonidine stimulation test was conducted. Treatment with rGH was initiated at a dose of 0,05 mg/ kg/day subcutaneously daily in the evening for one year. A separate group of patients with TS having GH deficiency (complete or partial) (n=23) were prescribed rGH at a dose of 0,03 mg/kg/day. Results and discussion. The average age for commencement of treatment with rGH in Ukraine is(11,74+-3,79) years. Treatment begins in girls with TS in 48,14% before the age of 12years and 51,85% ? over 12 years. 35,65% of girls with TS reported partial or complete deficiency of growth hormone. Early treatment of girls with Turner syndrome with rGH promotes its efficiency, but the beginning of treatment over the age of 12 years, results in the preservation of stunting and makes it impossible to achieve a socially acceptable definitive height. In the presence of growth hormone deficiency in patients it is advisable to treat with rGH at a dose of 0,03 mg/kg/day, with dose correction every 6 months if necessary. Treatment with rGH in patients with TS, older than 12 years with subnanism and growth retardation in combination with the presence of independent precocious puberty and normal growth hormone levels is inappropriate.