Congenital Adrenal Hyperplasia

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re: Somatropin therapy and leukemia
Aug. 16th, 2008   11:21am
When we were faced with a choice of whether to give GH to our daughter with Nonclassical, we chose not to. The decision was based less on a fear of leukemia (THE LANCET • Vol 360 • July 27, 2002 • www.thelancet.com) and more because we did not want to have to inject our child with a needle every day for a couple of years merely for an inch or two of height. It just did not seem worth it, or the risk of the unknown--could she have a reaction, in 10 years what if they discover out some unforeseen risk (like the Lancet study).
So, we made this decision, and she is a happy, but petite young lady. Of course, things are always different for boys, but will 2 inches of height really impact his overall quality of life? That is usually the best you can hope for with CAH and GH, as I understand it. Maybe it could be better to optimize the glucocorticoid treatment to minimize the suppression of noctural GH (try the pump or circadian rhythm dosing and make sure he is on the lowest dose possible--10-12 mgs/m2--don't go entirely by blood levels because they are always very elevated in boys in puberty and he can become oversuppressed if the doctors throw steroids on him to suppress it, and this will slow down his nocturnal GH secretion ) and look into aromatase inhibitors that stop the bone age from advancing in boys with few side effects.

Well, that is my opinion and our decision.

Anon




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