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Journal of Tropical Pediatrics 1995 41(5):285-289; doi:10.1093/tropej/41.5.285
© 1995 by Oxford University Press
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Circulating Growth Hormone (GH), Insulin-like Growth Factor-I (IGF-I) and Free Thyroxine, GH Response to Clonidine Provocation and CT Scanning of the Hypothalamic-pituitary Area in Children with Sickle Cell Disease

Ashraf T. Soliman, MD*,, Assim Darwish, MD**, H Mohammed, MD**, Mohammed R Bassiony, MD***, Nagwa El Banna, MD* and Maurice Asfour, MD{dagger}

*Departments of Pediatrics, The Royal Hospital and Qaboos University, College of Medicine Sultanate of Oman
**Departments of Radiology, The Royal Hospital and Qaboos University Sultanate of Oman
***College of Medicine, The Royal Hospital and Qaboos University Sultanate of Oman
{dagger}Department of Endocrinology, The Royal Hospital and Qaboos University Sultanate of Oman

Dr Ashraf T. Soliman, Pediatric Endocrinology, Royal Hospital, PO Box 1331 Seeb, Muscat, Sultanate of Oman.

Serum growth hormone (GH), cortisol, free thyroxine (FT4), thyroid-stimulating hormone (TSH), and insulin like growth factor I (IGF-I) concentrations were measured in 15 children with sickle cell disease (SCD) together with their heights < 5th percentile for age and gender, and in 15 healthy age-matched children who bad normal variant short stature (NVSS). GH response to an oral dose of clonidine (0.15 mg/m2) and cortisol response to ACTH stimulation were determined in the two groups.

Children with SCD had significantly lower serum concentrations of IGF-I and decreased GH response to stimulation. Eight out of the 15 children with SCD did not mount an appropriate GH response to clonidine provocation (< 10 µg/I). CT scanning of the hypothalamic-pituitary area in those eight children with SCD revealed a partial or complete empty sella in all of them. It appears that defective GH release, and consequently low IGF-I production and slow growth velocity in children with SCD might be secondary to hypoxic-vascular insults to their hypothalamic-pituitary axis during one or more of the sickling episodes.


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