Tratamento da baixa estatura idiopática : experiência da unidade de endocrinologia pediátrica
Resumo
Resumo : Objective: To evaluate the efficacy of treatment of children and adolescents with idiopathic short
stature (ISS) attended at a Public University Hospital in Brazil.
Patients and methods: Review of 134 charts of patients with indication for recombinant growth
hormone (GHr) between May 2007 and May 2017 and collection of the following data: sex,
chronological age, weight and length at birth, pubertal stage, Z-score of target stature (TS), GH
peak with clonidine and/or insulin hypoglycemia, prescribed GHr dose, adjuvant treatment,
duration of treatment, final stature (FS) Z-score. Stature Z-score and Z-score of the final stature
prevision (FSP) were obtained pre-treatment and annually.
Results: 65 patients fulfilled the ISS criteria; 33 were on treatment (> 12 months) and 10 reached
FS. IGF-1 was normal in 92.3% and all had one or both of the responsive stimulus tests (peak >
5.0 ng/mL). The Z-score of stature at the 1st, 2nd, 3rd, 4th (p <0.01) and 5th (p = 0.01) years of
treatment were higher than the Z-score of initial stature. The FSP Z-score at the 1st, 2nd, 3rd (p
<0.01) and 4th years (p = 0.01) of treatment was higher than the Z-score of the initial FSP. All
patients who achieved FS used adjuvant treatment. The FS Z-score was not different from the TS
Z-score (p = 0.24). Stature gain ranged from 0.9 to 7.9 cm.
Conclusion: The treatment of children with ISS is safe and effective, but with great variability of
response. Its administration should be individualized considering psychosocial benefits, adverse
effects and costs.