Skip to main content
Springer Nature Link
Log in

Rheumatoid arthritis and growth retardation in children: Treatment with human growth hormone

  • Original Investigations
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Twenty patients with rheumatoid arthritis or Still's disease associated with growth failure were treated with human growth hormone, 7.5 to 17 U/m2 body surface per week.

Five patients did not respond with better growth. In the remainder the mean growth rate increased from 1.9 cm/year (range: 0 to 3.3) to 6.2 cm/year (range: 3.6 to 12) over 5 to 7 months. Twelve patients treated for longer periods increased their mean growth rate from 2.3 cm/year (range: 0.7 to 5.7) to 6.3 cm/year (range: 2.4 to 9.7) and continued to grow during a second year of treatment. Growth velocity decreased in 6 patients when the hGH therapy was discontinued.

The causes for this improvement in growth are possibly multifactorial: the growth rate is depressed by the severity of the disease and high-dose glucocorticoid therapy. Increases of growth rate occured during improvements in the disease, reduction of steroid medication, as a result of therapy with human growth hormone, and because of puberty in some patients.

Human growth hormone seemed to improve the underlying condition of four of the patients but had no influence on the disease in the remaining children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ansell, B. M., Bywaters, E. G. L.: Growth in Still-disease. Ann. Rheumat. Dis. 15, 295 (1956)

    Google Scholar 

  2. Aynsley-Green, A., Zachmann, M., Prader, A.: Interrelation of therapeutic effects of growth hormone and testosterone on growth in hypopituitarism. J. Ped. 89, 992 (1976)

    Google Scholar 

  3. Blodgett, F. M., Burgin, L., Jessoni, P., Gribetz, D., Talbot, N. D.: Effects of prolonged cortisone therapy on the statural growth, skeletal maturation and matabolic status of children. New Engl. J. Med. 254, 636 (1956)

    Google Scholar 

  4. Butenandt, O.: Humanes Wachstumshormon. Seine Wirkung auf Wachstum und Stoffwechsel minderwüchsiger Kinder. Stuttgart: F. Enke 1974

    Google Scholar 

  5. Butenandt, O.: Partieller Wachstumshormonangel: Endogener Wachstumshormongehalt und Wirkung von exogen zugeführtem Wachstumshormon. Klin. Wschr. 51, 266 (1973)

    Google Scholar 

  6. Butenandt, O., Eder, R., Clados-Kelch, A.: Wachstumshormonbestimmungen bei Kindern mit rheumatoider Arthritis und Still-Syndrom. Verh. Dtsch. Ges. Rheumatol. 4, 47 (1976)

    Google Scholar 

  7. Butenandt, O., Kelch, A., Rajmann, E.: Growth hormone studies in patients with rheumatoid arthritis with or without glucocorticoid therapy. Z. Kinderheilk. 118, 53 (1976)

    Google Scholar 

  8. Butenandt, O., Knorr, D., Stoeber, E.: Die Ursachen der Wachstumshemmung bei der rheumatoiden Arthritis (primär chronischen Polyarthritis) im Kindesalter. Z. Rheumafrschg. 21, 280 (1962)

    Google Scholar 

  9. Foley, Th. P., Thompson, R. G., Shaw, M., Baghdassarian, A., Nissley, P. S., Blizzard, R. M.: Growth responses to human growth hormone in patients with intrauterine growth retardation. J. Ped. 84, 635 (1974)

    Google Scholar 

  10. Greulich, W. W., Pyle, S. I.: Radiographic atlas of skeletal development of the hand and wrist. 2nd Edition. Stanford University Press 1959

  11. Harter, J. G., Reddy, W. J., Thorn, G. W.: Studies on an intermittent corticosteroid dosage regimen. New Engl. J. Med. 269, 591 (1963)

    Google Scholar 

  12. Jasin, H. E., Fink, C. W., Wisse, E. W., Ziff, M.: Relationship between urinary hydroxyproline and growth. J. Clin. Invest. 41, 1928 (1962)

    Google Scholar 

  13. Job, J. C., Sizonenko, P., Pakey, J. P., Pakey, P., Bourdon, R., Rossier, A.: L'Hydroxyproline urinaire chez l'infant normal et dans les retards de croissance. Arch. franç. Péd. 23, 679 (1966)

    Google Scholar 

  14. Joss, E. E., Zuppinger, K. A.: The significance of intermediate plasma growth hormone levels in growth-retarded children. J. Ped. 81, 1092 (1972)

    Google Scholar 

  15. Kienböck, R.: Über infantile chronische Polyarthritis. Fortschr. Röntgenstr. 23, 343 (1915/1916); 24, 65 (1916)

    Google Scholar 

  16. Kölle, G.: Langzeittherapie der rheumatoiden Arthritis des Kindes. Mschr. Kinderheilk. 118, 505 (1970)

    Google Scholar 

  17. Knorr, D., Butenandt, O.: Zur Behandlung des hypophysären Zwergwuchses mit anabolen Steroiden. Z. Kinderheilk. 86, 489 (1962)

    Google Scholar 

  18. Kuhns, J. G., Swaim, L. T.: Disturbances of growth in chronic arthritis in children. Amer. J. Dis. Child. 43, 1118 (1932)

    Google Scholar 

  19. Laaksonen, A.-L.: A prognostic study of juvenile rheumatoid arthritis. Acta paed. Scand. Suppl. 166 (1966)

  20. MacGillivray, M. H., Kolotkin, M., Munschauer, R. W.: Enhanced linear growth responses in hypopituitary dwarfs treated with growth hormone plus androgen versus growth hormone alone. Pediat. Res. 8, 103 (1974)

    Google Scholar 

  21. Prader, A., Tanner, J. M., v. Harnack, G. A.: Catch-up growth following illness or starvation. J. Ped. 62, 646 (1963)

    Google Scholar 

  22. Preece, M. A.: Effect of administered corticosteroids on growth in children. Postgrad. Med. J. 52, 625 (1976)

    Google Scholar 

  23. Rudman, D., Freides, D., Patterson, J. H., Gibbas, D. L.: Diurnal variation in the responsiveness of human subjects to human growth hormone. J. clin. Invest. 52, 912 (1973)

    Google Scholar 

  24. Sänger, L.: Klinische Verlaufsuntersuchung der Wachstumsretardierung von Kindern mit rheumatoider Arthritis und Still-Syndrom. Mschr. Kinderheilk. 122, 331 (1974)

    Google Scholar 

  25. Sänger, L.: Klinische Studie über schwere Wachstumsretardierung bei juveniler rheumatoider Arthritis und Still-Syndrom. Verh. Dtsch. Ges. Rheumatol. 4, 42 (1976)

    Google Scholar 

  26. Stoeber, E., Kölle, G.: Klinik und Therapie der primär chronischen Polyarthritis im Kindesalter. Med. Klin. 51, 2197 (1956)

    Google Scholar 

  27. Sturge, R. A., Beardwell, C., Hartog, M., Wright, D., Ansell, B. M.: Cortisol and growth hormone secretion in relation to linear growth: Patients with Still's disease on different therapeutic regimens. Brit. Med. J. III, 547 (1970)

    Google Scholar 

  28. Tanner, J. M., Whitehouse, R. H.: Growth response of 26 children with short stature given human growth hormone. Brit. Med. J. II, 69 (1967)

    Google Scholar 

  29. Tanner, J. M., Whitehouse, R.: Clinical longitudinal standards for height, weight, height velocity and weight velocity and stages of puberty. Arch. Dis. Child. 51, 170 (1976)

    Google Scholar 

  30. Tanner, J. M., Whitehouse, R. H., Hughes, P. C. R., Carter, B. S.: Relative importance of growth hormone and sex steroids for growth at puberty of trunk length, limb length and muscle width in growth-hormone-deficient children. J. Ped. 89, 1000 (1976)

    Google Scholar 

  31. Tanner, J. M., Whitehouse, R. H., Takaishi, M.: Standards from birth to maturity for height, weight, height velocity and weight velocity: British children. Arch. Dis. Child. 41, 454 and 613 (1966)

    Google Scholar 

  32. Ward, D. J., Hartog, M., Ansell, B. M.: Corticosteroid-induced dwarfism in Still's disease treated with human growth hormone. Ann. Rheum. Dis. 25, 416 (1966)

    Google Scholar 

  33. Wright, J. C., Brasel, J. A., Aceto, T., Finkelstein, J. W., Kenny, F. M., Spaulding, J. S., Blizzard, R. M.: Studies with human growth hormone (HGH): attempt to correlate metabolic response during short-term administration with linear growth during prolonged therapy. Am. J. Med. 38, 499 (1965)

    Google Scholar 

  34. Zutshi, D. W., Friedman, M., Ansell, B. M.: Corticotrophin therapy injuvenile chronic polyarthritis (Still's disease) and effect on growth. Arch. Dis. Child. 46, 584 (1971)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Universitätskinderklinik im Dr. von Haunerschen Kinderspital, München, Federal Republic of Germany

    Otfrid Butenandt

  2. Abteilung für pädiatrische Endokrinologie, Lindwurmstr.4, D-8000, München 2, Federal Republic of Germany

    Otfrid Butenandt

Authors
  1. Otfrid Butenandt
    View author publications

    You can also search for this author inPubMed Google Scholar

Additional information

On the occasion of the 75th birthday of Prof. Dr. Dr. h. c. Adolf Butenandt

Rights and permissions

Reprints and permissions

About this article

Cite this article

Butenandt, O. Rheumatoid arthritis and growth retardation in children: Treatment with human growth hormone. Eur J Pediatr 130, 15–28 (1979). https://doi.org/10.1007/BF00441894

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00441894

Key words