Treatment by hGH of constitutional delay of growth and adolescence.

In constitutional delay of growth and adolescence (CDGA), all growth and maturation parameters are delayed by 2-4 years. Provocation tests of hGH secretion give normal values, but spontaneous (endogenous) secretion is low. This can be assessed by measuring night-time hGH secretion, when the differences between normal subjects and CDGA patients are highly significant. Replacement therapy with hGH produced growth spurts in all but one patient, improving their growth prognosis. A new series of 16 CDGA patients has now been treated with hGH for 1-3 years. Catch-up growth was seen during the first year, which decreased to normal growth velocity by the third year. This normal growth rate is still faster than the pretreatment velocity. Although hGH therapy may be effective in CDGA, it may only be justified in cases with psychological problems arising from their short stature.