Growth hormone improves growth in specific cases .
At age 25 , Lionel Messi is considered the best player of current football. And yet , 10 years ago, he used to measure 1.10 m and doctors found it does not exceed 1.50 m in adulthood due to hormonal disease . Treatment with growth hormone allows the young player to reach its current size of 1.69 m and become a soccer star .
All the children for their age are not covered by treatment with somatotropin ( synthetic growth hormone ), which is tightly controlled prescription . But for some , do not grow can be a sign of pathology discovered during a consultation for a problem. “Parents come to us saying :” Our child is the smallest in its class , ‘”says Dr. Gilbert Simonin , an endocrinologist at the Timone (Marseille).
Each time “Children come to our offices with the same words , they are treated garden gnome , are upset in the playground ,” says Professor Peter Bougnères , an endocrinologist at the Bicetre hospital.
standard deviation
In adolescence, the eyes of others becomes particularly cruel. Sometimes it is too late. ” When you explain a 14 year old girl that growth is over and it measured 1.44 m, it is a disaster for her. It is often more painful than announce diabetes at the same age , says Pierre Bougnères .
This is why we need to worry about early one size too small for age. Additional tests will then check if it is a simple delay or if there is underlying disease . “We undertake from a size – 2 SD (standard deviation ), explains Gilbert Simonin . The standard deviation is the value that is used to evaluate the growth of a child. When all children are measured by age group , and an average size range is determined. Nearly 95 % of children are between – 2 (for smaller ones) and 2 + (for larger) standard deviation. Below – 2 SD , the child is no longer in the “standard” .
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Five* very different pathologies
Investigations will discover a growth hormone deficiency , Turner syndrome , abnormal gene Shox or … nothing. In France , prescription somatotropin is allowed in case of growth hormone deficiency and in some other case. In total more than twenty-five thousand non deficient children with growth hormone would be eligible for treatment . But this number covers very different pathologies. Five in total.
Turner syndrome , due to the absence of all or part of chromosome X in the female, resulting in a malfunction more ovary ; genetic disease Prader Willi , also characterized by decreased muscle tone at birth; the abnormal gene Shox ; growth retardation associated with chronic renal failure and growth retardation in children born small for gestational age .
A child born small for gestational age has a size and a lower weight – 2 DS at birth. In this case, one in ten children do not catch up the delay and has a mature height between 1.45 m and 1.50 m for females and 1.50 m and 1.60 m for boys. In the United States , small size say constitutional , family origin, can be treated with growth hormone (which saves a few centimeters) , but not in France or Europe.
Treatment of non- deficient children with growth hormone was on the spot and the delisting was considered in this case. After an adversarial procedure , the opinion of the High Authority for Health (HAS ) , Le Figaro has obtained , maintains 100% refund . “This reassessment of growth hormone has been difficult because it concerned a variety of diseases and conditions ,” said Professor Jean -Luc Harousseau , President of HAS.
6000 to 10,000 euros per year
For endocrinologists and patients’ associations , the service rendered by growth hormone is not discussed . “This is a real handicap to measure 1.50 m in our society when a man ” says Professor Juliane Léger, an endocrinologist at the Hôpital Robert Debré ( Paris ) . “It is also true that these treatments cost from 6000 to 10000 per year. We need to know to stop if there is no acceleration of growth after a year. ” Notice of HAS on Monday concerning reimbursement but believes ” do not have enough data to confirm or deny the efficacy and safety of growth hormone . “