Short stature is a common feature in Turner’s syndrome; (TS) final height in untreated patients is on average 20cm below the population mean for adult women. When recombinant growth hormone (GH) became available, supraphysiologic GH doses with or without oxandrolone (OX) were administrated in order to improve growth in patients wih TS in several studies Objective: The objective of this study was to find out whether moderate doses of growth hormone in combination with oxandrolone and late initiation of puberty could improve adult height even in TS patients with late diagnosis. Materials and Methods: In this study the data an 68 patients with TS will be reported. Thirtythree patients with chronological age 17 years or above did not receive treatment. Thirty- five patients with TS were randomly assigned to receive either GH alone (0.375 mg/kg/week) by daily S.C injections (Group GH, n = 23) or in combination with OX 6 mg/kg/day P.O (group GH + OX, n = 12). Mean age at the onset of treatment was 10.7 years (GH) and 10.3 years (GH+OX), mean projected adult height (PAH) was 142.1 cm (GH) and 141.5 cm (GH+ ox). Puberty was induced at a mean age of 14.5 years. Results: There was a marked difference in group GH ± OX cumulative growth during 4.3 years of therapy in comparison with untreated TS patients. Twenty-six patients are now near or at final height: Group GH (n=17), mean final height was 148.7 cm (PAH 142.1 cm, gain 6.6 cm); group GH+ OX (n = 9), 151.9 cm (PAH, 141.5 cm, gain 9.4 cm). In the untreated group (n = 33), mean final height was 139.1 cm. Cumulative growth was more significant in GH plus OX than GH alone treated subjects (P<0.001). Conclusion: The diagnosis of TS is often delayed in our country and this defers the timely and appropriate treatment of short stature. Our results are in keeping with studies demonstrating moderate doses of GH plus OX and late induction of puberty are able to improve final height even in patients with TS, treated relatively late.
Growth hormone therapy
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