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Growth rates and the prevalence and progression of scoliosis in short-statured children on Australian growth hormone treatment programmes.

Day GA, McPhee IB, Batch J, Tomlinson FH - Scoliosis (2007)

Bottom Line: STUDY DESIGN AND AIM: This was a longitudinal chart review of a diverse group (cohort) of patients undergoing HGH (Human Growth Hormone) treatment.In this study, there was no evidence of HGH treatment being responsible for progression of scoliosis in a small number of non-syndromic patients (four).An incidental finding was that scoliosis, similar to the idiopathic type, appears to be more prevalent in Turner syndrome than previously believed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, University of Queensland, Brisbane, Australia. ggandlda@bigpond.net.au

ABSTRACT

Unlabelled: STUDY DESIGN AND AIM: This was a longitudinal chart review of a diverse group (cohort) of patients undergoing HGH (Human Growth Hormone) treatment. Clinical and radiological examinations were performed with the aim to identify the presence and progression of scoliosis.

Methods and cohort: 185 patients were recruited and a database incorporating the age at commencement, dose and frequency of growth hormone treatment and growth charts was compiled from their Medical Records. The presence of any known syndrome and the clinical presence of scoliosis were included for analysis. Subsequently, skeletally immature patients identified with scoliosis were followed up over a period of a minimum four years and the radiologic type, progression and severity (Cobb angle) of scoliosis were recorded.

Results: Four (3.6%) of the 109 with idiopathic short stature or hormone deficiency had idiopathic scoliosis (within normal limits for a control population) and scoliosis progression was not prospectively observed. 13 (28.8%) of 45 with Turner syndrome had scoliosis radiologically similar to idiopathic scoliosis. 11 (48%) of 23 with varying syndromes, had scoliosis. In the entire cohort, the growth rates of those with and without scoliosis were not statistically different and HGH treatment was not ceased because of progression of scoliosis.

Conclusion: In this study, there was no evidence of HGH treatment being responsible for progression of scoliosis in a small number of non-syndromic patients (four). An incidental finding was that scoliosis, similar to the idiopathic type, appears to be more prevalent in Turner syndrome than previously believed.

No MeSH data available.


Related in: MedlinePlus

PA plain radiograph Turner syndrome scoliosis.
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Figure 1: PA plain radiograph Turner syndrome scoliosis.

Mentions: Of 45 with Turner syndrome, one had congenital scoliosis and underwent scoliosis surgery at age 13. Curve progression was not recorded for this patient. Thirteen of the 45 (28.8%) had scoliosis radiologically indistinguishable from idiopathic scoliosis (Figures 1, 2, 3). The mean age at diagnosis of scoliosis was 13 (range 3–22 years). All had oestrogen supplementation for delayed puberty. The site/morphology of the scoliosis and karyotype was recorded (Table 3). One had scoliosis prior to the commencement of HGH treatment and two others were diagnosed with scoliosis within one year of commencing the HGH treatment programme. The deformity subsequently progressed in both, resulting in right thoracic curves of 45°. Another underwent surgery for the scoliosis deformity, during HGH treatment. Analysis of the Turner syndrome subgroup revealed that they were administered a larger average dose of growth hormone (milligrams per kilogram body weight) (p = 0.003) and were commenced on the OZGROW program at an earlier age (p < 0.001) than the group comprising idiopathic short stature. The magnitude of the scoliosis curve in Turner syndrome was not influenced by the duration of HGH therapy.


Growth rates and the prevalence and progression of scoliosis in short-statured children on Australian growth hormone treatment programmes.

Day GA, McPhee IB, Batch J, Tomlinson FH - Scoliosis (2007)

PA plain radiograph Turner syndrome scoliosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1808441&req=5

Figure 1: PA plain radiograph Turner syndrome scoliosis.
Mentions: Of 45 with Turner syndrome, one had congenital scoliosis and underwent scoliosis surgery at age 13. Curve progression was not recorded for this patient. Thirteen of the 45 (28.8%) had scoliosis radiologically indistinguishable from idiopathic scoliosis (Figures 1, 2, 3). The mean age at diagnosis of scoliosis was 13 (range 3–22 years). All had oestrogen supplementation for delayed puberty. The site/morphology of the scoliosis and karyotype was recorded (Table 3). One had scoliosis prior to the commencement of HGH treatment and two others were diagnosed with scoliosis within one year of commencing the HGH treatment programme. The deformity subsequently progressed in both, resulting in right thoracic curves of 45°. Another underwent surgery for the scoliosis deformity, during HGH treatment. Analysis of the Turner syndrome subgroup revealed that they were administered a larger average dose of growth hormone (milligrams per kilogram body weight) (p = 0.003) and were commenced on the OZGROW program at an earlier age (p < 0.001) than the group comprising idiopathic short stature. The magnitude of the scoliosis curve in Turner syndrome was not influenced by the duration of HGH therapy.

Bottom Line: STUDY DESIGN AND AIM: This was a longitudinal chart review of a diverse group (cohort) of patients undergoing HGH (Human Growth Hormone) treatment.In this study, there was no evidence of HGH treatment being responsible for progression of scoliosis in a small number of non-syndromic patients (four).An incidental finding was that scoliosis, similar to the idiopathic type, appears to be more prevalent in Turner syndrome than previously believed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, University of Queensland, Brisbane, Australia. ggandlda@bigpond.net.au

ABSTRACT

Unlabelled: STUDY DESIGN AND AIM: This was a longitudinal chart review of a diverse group (cohort) of patients undergoing HGH (Human Growth Hormone) treatment. Clinical and radiological examinations were performed with the aim to identify the presence and progression of scoliosis.

Methods and cohort: 185 patients were recruited and a database incorporating the age at commencement, dose and frequency of growth hormone treatment and growth charts was compiled from their Medical Records. The presence of any known syndrome and the clinical presence of scoliosis were included for analysis. Subsequently, skeletally immature patients identified with scoliosis were followed up over a period of a minimum four years and the radiologic type, progression and severity (Cobb angle) of scoliosis were recorded.

Results: Four (3.6%) of the 109 with idiopathic short stature or hormone deficiency had idiopathic scoliosis (within normal limits for a control population) and scoliosis progression was not prospectively observed. 13 (28.8%) of 45 with Turner syndrome had scoliosis radiologically similar to idiopathic scoliosis. 11 (48%) of 23 with varying syndromes, had scoliosis. In the entire cohort, the growth rates of those with and without scoliosis were not statistically different and HGH treatment was not ceased because of progression of scoliosis.

Conclusion: In this study, there was no evidence of HGH treatment being responsible for progression of scoliosis in a small number of non-syndromic patients (four). An incidental finding was that scoliosis, similar to the idiopathic type, appears to be more prevalent in Turner syndrome than previously believed.

No MeSH data available.


Related in: MedlinePlus