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Growth hormone in children with idiopathic short stature

BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d1248 (Published 14 March 2011) Cite this as: BMJ 2011;342:d1248

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growth hormone in idiopathic short stature

In my view Professor Albertsson-Wikland overstates the case for
treating idiopathic short stature with growth hormone. The results overall
are a modest 4cm in adult height with no evidence supplied that this is
actually beneficial either physically or psycologically; the very long
term effects are still unknown yet the potential side-effects of GH are
well known; and the studies may have been confounded by including small-
for-dates babies. He also states that child growth is an integrated marker
of health but does not state whether this applies to normal children. The
latter is the crux of the matter. These children are small but normal.By
definition they do not have a recognisable disease state as most of us
understand it. This 'illness' seems to be wholely defined by statistics
and parental over-expectations. i do not see children with idiopathic high
stature being offered given GH antagonists.
In view of this, I have serious doubts about the ethics of this
"treatment" for a poorly defined "illness".

Competing interests: No competing interests

20 March 2011
Paul J Caldwell
gp
sessional