Debate: Idiopathic short stature should be treated with growth hormone

Authors

  • Geoffrey R Ambler,

    Corresponding author
    1. Institute of Endocrinology and Diabetes, Sydney Children's Hospitals Network (Westmead Campus)
    2. Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales
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  • Jan Fairchild,

    1. Department of Paediatric Endocrinology and Diabetes, Women's and Children's Hospital
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  • Dominic JC Wilkinson

    1. The Robinson Institute, Discipline of Obstetrics and Gynecology, University of Adelaide, Adelaide, South Australia, Australia
    2. Program on Ethics and the New Biosciences, Oxford Uehiro Centre for Practical Ethics, The University of Oxford, Oxford, United Kingdom
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Professor Geoffrey Ambler, Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW 2145, Australia. Fax: +61 29845 3170; email: geoffa@chw.edu.au

Abstract

In this paper we outline the case for and against the treatment of idiopathic short stature with growth hormone. Drs Ambler and Fairchild argue that many of those with ‘idiopathic’ short stature are not ‘short, normal children’ and will ultimately receive molecular diagnoses. They also argue that there is a subset of children who suffer negative psychosocial consequences of their stature for whom growth hormone therapy is effective. Growth hormone has a very good safety record and is likely to be as cost-effective in idiopathic short-stature as in some other conditions that are currently funded. Dr Wilkinson counters that short stature is not associated with physical or psychological illness, and that there is no evidence that growth hormone improves psychological or physical wellbeing. Moreover, growth hormone for idiopathic short stature represents a form of enhancement rather than treatment, and is not a fair use of resources. Socially mediated disadvantage should be treated by attention to prejudice and not by hormone treatment.

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