Growth failure

Human growth hormone, used as a human pharmaceutical, is approved for only one indication in the United States, treatment of growth failure owing to hGH deficiency, a condition known as pituitary dwarfism. However, clinical trials are under way to test its efficacy in Turner s syndrome, bums, wound healing, cachexia, osteoporosis, constitutional growth delay, aging, malnutrition, and obesity. 

Growth failure due to deficiency of pituitary growth hormone in children... 

CD occurs in approximately 4.56 per 100,000 pediatric patients, and UC occurs in about 2.14 cases per 100,000.43 A major issue in children with IBD is the risk of growth failure secondary to inadequate nutritional intake. Failure to thrive may be an initial presentation of IBD in this population. Aggressive nutritional interventions may be required to facilitate adequate caloric intake. Chronic corticosteroid therapy may also be associated with reductions in growth. 

Obtain a thorough history and physical examination that may indicate the possible presence of GH deficiency. Exclude other identifiable causes of growth failure, such as hypothyroidism, chronic illness, malnutrition, genetic syndromes, and skeletal disorders. 

Mecasermin rinfibate (Iplex and Increlex ) is the only recombinant once-daily IGF-I replacement therapy for the treatment of growth failure in children with severe primary IGF-I deficiency or with GH gene deletions who have developed neutralizing antibodies to GH. This product has not been evaluated in patients with GH deficiency aside from the genetic abnormalities. 

Increlex (mecasermin, rh IGF-1) Growth failure in children Tercica/Baxter... 

Iplex (mecasermin rinfabate, complex Growth failure in children Insmed... 

Nutropin AQ Schwartz Pharma AG Growth failure, Turner s syndrome... 

Norditropin Novo Nordisk Treatment of growth failure in children due to inadequate growth hormone secretion... 

Intrauterine seizures may occur. The electroencephalogram often displays a hypsarrhythmia or a burst-suppression pattern. Patients display myoclonic jerks, hiccuping and a profound hypotonia. The few patients who survive past the first week usually sustain profound mental retardation and neurological disability. Brain imaging shows atrophy and a loss of myelin. Rarely, patients present later in life with psychomotor retardation and growth failure. Others have had initial normal development followed by a progressive loss of developmental milestones. Some patients have manifested spinocerebellar degeneration and other symptoms of motor dysfunction [27],... 

Cobalamin-c disease remethylation of homocysteine to methionine also requires an activated form of vitamin B12. In the absence of normal B12 activation, homocystinuria results from a failure of normal vitamin B12 metabolism. Complementation analysis classifies defects in vitamin B12 metabolism into three groups cblC (most common), cblD and cblF. Most individuals become ill in the first few months or weeks of life with hypotonia, lethargy and growth failure. Optic atrophy and retinal changes can occur. Methylmalonate excretion is excessive, but less than in methylmalonyl-CoA mutase deficiency, and without ketoaciduria or metabolic acidosis. 

Diagnosis of a urea cycle defect in the older child can be elusive. Patients may present with psychomotor retardation, growth failure, vomiting, behavioral abnormalities, perceptual difficulties, recurrent cerebellar ataxia and headache. It is therefore essential to monitor the blood ammonia in any patient with unexplained neurological symptoms, but hyperammonemia is inconstant with partial enzymatic defects. Measurement of blood amino acids and urinary orotic acid is indicated. 

Animal models for OTC deficiency include the sparse fur (spf) mouse (15% control enzyme activity) and the sparse fur-abnormal skin and hair (spf-ash) mouse (5% of control). Both kinds of mutant mouse manifest hyperammonemia, orotic aciduria, growth failure and sparse fur. 

Lysinuric protein intolerance. Infants manifest growth failure, hepatosplenomegaly, vomiting, hypotonia, recurrent lethargy, coma, abdominal pain and, in rare instances,... 

Daily energy requirements for children are approximately 150% of basal metabolic rate with additional calories to support activity and growth (Table 57-5). Requirements increase with fever, sepsis, major surgery, trauma, burns, long-term growth failure, and chronic conditions (e.g., bronchopulmonary dysplasia, congenital heart disease, and cystic fibrosis). 

Norman Carl Wetzel, The Treatment of Growth Failure in Children, NEA Service, Cleveland, Ohio, 1948. 

Musculoskeletal Myopathy Growth failure Osteopenia Ocular... 

With increased availability of GH, other chnical uses could be explored, such as growth failure due to Turner syndrome [9], chronic renal insufficiency [10], Prader-... 

H. Other considerations Protropin has been designated an orphan product for use in the treatment of growth failure due to... 

Growth failure due to an inadequate secretion of endogenous growth hormone, Prader-Willi syndrome (PWS), adults with growth hormone deficiency (GHD) of either childhood- or adult-onset etiology... 

Pediatric patients who have growth failure due to an inadequate secretion of normal endogenous growth hormone... 

Weeda G, Donker I, de Wit J et al. Disruption of mouse ERCCl results in a novel repair syndrome with growth failure, nuelear abnormalities and seneseenee. CurrBiol 1997 7 427 39. 

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