Growth hormone in growth hormone deficiency

doi:10.1136/bmj.325.7371.1037/c

BMJ 2002;325:1037 ( 2 November )

Letters

Growth hormone in growth hormone deficiency

Ignore the evidence and keep going wrong

Deficiency cannot be diagnosed solely on the results of stimulation tests

Ignore the evidence and keep going wrong

The first 150 words of the full text of this article appear below.

EDITOR $---$ We were surprised that in his editorial to our paper Saenger challenged our conclusions that most patients treatedfor growth hormone deficiency do not have this condition, andthat controlled trials should be organised to evaluate the longterm effects of growth hormone in most of the patients currentlytreated.¹ Saenger supports the use of an integrated approachto diagnosing growth hormone deficiency and the wider use of IGF-1measurements, as suggested by the Growth Hormone Research Society.However, his recent publications, as coauthor or senior author,do not reflect his plea. ² ³ This contradiction reflects thewidespread contrast between the recommendations in consensus guidelinesand current practice or clinical researchprotocols.

In the absence of a gold standard, how can growth hormone deficiency be defined? We propose using long term results of treatmentin comparison with spontaneous outcome. The results of our observationalstudy indicate that most patients . . . [Full text of this article]

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