A B S T R A C T The effects of administered human growth hormone (HGH) were evaluated in dwarfed, prepubertal children who were receiving long-term corticosteroid therapy for a chronic dis- ease. During 11 complete metabolic balance stud- ies, the eight corticosteroid-treated children dem- onstrated impaired response to large doses of HGH with minimal nitrogen and no phosphorus retention. In contrast, two hypopituitary subjects and two asthmatic children not receiving corti- costeroid responded to the same preparations of HGH with nitrogen, potassium, and phosphorus retention. Six corticosteroid-treated children were given large doses of HGH (40-120 mg/wk for 4 to 8 months and showed no improvement in their retarded rate of growth, whereas the hypo- pituitary subjects showed accelerated growth dur- ing administration of 10-15 mg of HGH/wk. It is concluded that dwarfism in steroid-treated chil- dren results from corticosteroid-induced antago- nism of the effects of HGH at the peripheral tissue level. TABLE I Clinical Data on Subjects for Metabolic Balance Study Height, deviation Patient Sex Age Diagnosis from mean Steroid dose Fasting HGH m~.g/ml P. L. M 12 Asthma -2.2 SD Prednisone, 5 mg b.i.d. 8.5 J. O'N. M 12 Asthma -2.6 sD Prednisone, 5 mg q.i.d. 14 C. B. F 12 Asthma -4.4 SD Study 1, no steroid Study 2, prednisone 2.5 mg t.i.d. 6 J. S. M 12 Asthma -3.7 SD Prenisone, 2.5 mg t.i.d. 1.5 M. K. F 12 Asthma -3.4 SD Prednisone, 5 mg b.i.d. 4.2 K. K. M 13.5 Asthma -4.0 SD Prednisone, 5 mg t.i.d. <1 M. P. F 12 Rheumatoid arthritis -5.5 SD Prednisone, 5 mg t.i.d. C. W. F 8 Nephrosis -4.0 SD Prednisone, 5 mg q.i.d. 10 E. LJ. M 12 Asthma -2.2 SD None 5.0 D. H. M 18 Panhypopituitarism None <1 J. M. F 16 Panhypopituitarism None <1
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Morris et al. (1968) studied this question.