We studied the growth‐promoting effect of treatment with recombinant human growth hormone in 23 prepubertal children with Noonan syndrome, aged between 5. 4 and 14. 3 y, and all with a height < 1. 4 SD for Tanner standards. The growth response and skeletal maturation after 1 y of recombinant human growth hormone treatment (0. 15 U/kg/day given by daily injection) in the Noonan syndrome patients was compared with the auxological changes observed in a group of 17 girls with Turner syndrome with a comparable age and height deficit who were treated with recombinant human growth hormone in a similar way. During 1 y of treatment, the mean ± SD height velocity increased by 4. 0 ± 1. 6 cm/y in the Noonan syndrome group and by 3. 6 ± 1. 3 cm/y in the Turner syndrome group. Height SDS for chronological age in the Noonan syndrome group increased by 0. 53 ± 0. 46 (p < 0. 001). In the Noonan syndrome patients the changes in height velocity were positively related to birthweight (r= 0. 48, p < 0. 05). The changes in height velocity or height SDS were not related to the age, height deficit or a delay in bone age maturation at start of treatment. In neither the patients with Noonan syndrome nor Turner syndrome was an acceleration of bone maturation found. We conclude that treatment with recombinant human growth hormone in pre‐pubertal NS patients induces an increase in height velocity and height SDS comparable to that observed in Turner syndrome girls.
Using a recently described radioisotopic technique, the separate glomerular filtration rate of 67 kidneys associated with vesicoureteric reflux has been determined. Normal values were found in only half of the kidneys. During an 18 month followup period, no significant change in separate glomerular filtration rate has been observed whatever the kind of treatment (Medical or surgical), the grade of reflux, the age of the patient at surgery or the initial degree of renal impairment.
THERE HAS BEEN substantial alteration of the perception of the clinical spectrum of diabetes and its etiologic heterogeneity in the past decade. This growth of knowledge has been important for both pediatric and adult patient populations. In 1979, the National Diabetes Data Group assembled international experts to revise classifications and nomenclature for diabetes mellitus in an effort to improve communication among practitioners and investigators and to incorporate newer concepts into a more appropriate terminology. In the deliberations of the National Diabetes Data Group, members of the Lawson Wilkins Pediatric Endocrine Society individually, and collectively, as the Committee on Diabetes, contributed advice which was incorporated into the final report. The purpose of this communication is to convey those portions of the National Diabetes Data Group report 1 pertinent to pediatric practice. The NDDG report did not deal with therapy.
