My wife sent me an e-mail this morning to let me know about an article published on-line at Salon.com entitled “Growth Hormone For Kids,” written by Rahul Parikh. The article addressed the question of whether short children who have no specific medical condition to explain their short stature should be treated with growth hormone injections. So, the question is whether children who have so-called “idiopathic short stature” should be treated with growth hormone with the intention of making them taller adults than they would otherwise be without the injections. The author comes down on the side of not treating such patients but the issue is actually rather complex and, in my opinion, there are no easy answers.
In 2003, the U.S. Food and Drug Administration (FDA) approved the use of growth hormone injections in idiopathic short stature with several caveats: the child must be short and growing at a rate that would not likely result in their achieving an adult height in the normal range, defined as 59 inches for a girl and 63 inches for a boy. In addition, the bone growth centers must be still open and the child must not have some medical condition that would explain the short stature.
I have no idea how many children in the U.S. have been and are currently receiving growth hormone injections for idiopathic short stature. I do not know of any insurers that cover the treatment, which can be quite expensive- as much as $50,000 or more per year. There is no consensus among pediatric endocrinologists (the docs who mostly deal with growth hormone treatment for short stature) whether short stature per se is a disease worthy of treatment with growth hormone or merely a cosmetic condition for which use of growth hormone should not be considered medically necessary (“medically necessary” is a term I discussed in one of my earlier entries and I would refer you to that in case you have forgotten what I wrote- actually, I can’t even remember what I wrote). Anyway, the article is interesting and the accompanying letters to the editor are particularly interesting. I even wrote a letter, which didn’t make the editor’s list of “the best 3 letters,” but you can find it on page 3 or 4 of the letters.
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