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Darrell M. Wilson, MD; Phillip D. K. Lee, MD; Alan H. Morris, MD; Edward O. Reiter, MD; Joseph M. Gertner, MB, MRCP; Robert Marcus, MD; Valerie E. Quarmby, PhD; Ron G. Rosenfeld, MD

Am J Dis Child. 1991;145(10):1165-1170.

Abstract
• The effects of growth hormone therapy on the biochemical measures of bone metabolism were studied in 11 children aged 3.5 to 17 years who had familial hypophosphatemic rickets; five were male. Subjects were maintained on a regimen of stable doses of conventional therapy (calcitriol and phosphate). Subjects were studied at baseline receiving conventional therapy and during three sequential treatment periods: no therapy (4 weeks), growth hormone only (0.05 mg/kg per day for 4 weeks), and conventional therapy plus growth hormone (2 weeks). The nine youngest subjects were continued on a regimen of triple therapy for an additional 24 weeks. Serum phosphate averaged 0.93±0.13 mmol/L (mean±SD) at entry and decreased when the subjects were not receiving any therapy. During the 4 weeks of growth hormone only treatment, phosphate rose in all 11 subjects (0.70±0.08 mmol/L to 0.83±0.08 mmol/L). With triple therapy, phosphate remained higher than with no therapy. Calcitriol, osteocalcin, and parathyroid hormone increased as the subjects received growth hormone alone. Insulinlike growth factor I z scores rose significantly in response to growth hormone therapy alone. All nine subjects receiving 6 months of triple therapy increased their growth rate z scores. Exogenous growth hormone therapy may be useful in familial hypophosphatemic rickets.

(AJDC. 1991;145:1165-1170)

Author Affiliations
From the Departments of Pediatrics, Stanford (Calif) University (Drs Wilson and Rosenfeld); University of Colorado Health Science Center, Denver (Dr Lee); The City of Hope Hospital, Duarte, Calif (Dr Morris); Baystate Medical Center, Tufts University of School of Medicine, Springfield, Mass (Dr Reiter); Cornell University Medical College, New York, NY (Dr Gertner); the Department of Medicine, Stanford University (Dr Marcus); and Peptide Section, Endocrine Sciences, Calabasas Hills, Calif (Dr Quarmby). Dr Lee is now with the Department of Pediatrics, Baylor College of Medicine, Houston, Tex.

Footnotes
Accepted for publication May 20, 1991.

Read in part before the Eighth Congress of the International Pediatric Nephrology Association, Toronto, Ontario, August 31, 1989, the Society of Pediatric Research, Anaheim, Calif, May 10, 1990, and the Third Eli Lilly International Symposium on Endocrine Disorders, Stanford, Calif, May 9, 1990.

Reprints not available.

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