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Journal of Tropical Pediatrics Advance Access published online on May 1, 2008
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmn030
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© The Author [2008]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Linear Growth, Growth-Hormone Secretion and IGF-I Generation in Children with Neglected Hypothyroidism Before and After Thyroxine Replacement

Ashraf T. Solimana, Magdy Omara, Ahmad El Awwaa, Mostafa M. Rizkb, Rania K. El Alailya and Elsaid M. A. Bedairc

aDepartments of Pediatrics
bClinical Pathology
cRadiology, University of Alexandria Children's Hospital, El Chatby, Alexandria, Egypt

Correspondence: Ashraf T. Soliman, Consultant Pediatric Endocrinologist, Department of Pediatrics, Hamad Medical Center, P. O. Box 3050, Doha, Qatar. Tel: 00974-5983874; Fax: 00974-4439571. E-mail < ATSOLIMAN{at}yahoo.com>.


  Abstract

We studied growth hormone (GH) stimulation and insulin-like growth factor -I (IGF-I) generation tests in 15 children with neglected congenital hypothyroidism (CH) (age = 6.4 ± 4.2 years) and measured their growth parameters for >1 years after starting thyroxine (T4) replacement. One year after treatment, height SDS (HtSDS) increased from –4.3 ± 2.5 to –2.7 ± 2.3. Peak GH response to clonidine increased from 3.2 ± 1.2 ng ml–1 to 7.62 ± 1.38 ng ml–1 after treatments. Basal and peak IGF-I response to GH increased from (34.66 ± 17.3 ng ml–1 and 58.4 ± 36.99 ng ml–1, respectively) before treatment to (130.6 ± 97.8 ng ml–1 and 193.75 ± 122.5 ng ml–1, respectively). HtSDS increments were correlated significantly with basal free T4 concentrations (r = 0.622, P < 0.01). In summary, after long period of hypothyroidism, T4 replacement produced significant, although incomplete, catch-up growth through a partial recovery of GH- IGF-I axis.


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