For height outcome , articles were limited to studies reporting adult height and to systematic review s. FINDINGS Recombinant human growth hormone therapy of children with idiopathic short stature increases height in some children .
The cost-benefit ratio is controversial .
AND RELEVANCE Growth hormone treatment may be considered in some children with idiopathic short stature
IMPORTANCE Approximately 2 % of children are defined as having short stature .
Deciding when to pursue recombinant human growth hormone therapy to increase adult height is controversial .
OBJECTIVE To review the management of children with idiopathic short stature , including diagnostic evaluation and therapeutic options .
Final height gain by GH therapy in children with idiopathic short stature is dose dependent.
Recombinant human GH therapy to children with idiopathic short stature ( ISS ) increases growth velocity , but its effect on final height ( FH ) is still uncertain . The aim of this study was to investigate the effect of recombinant human GH on FH of patients with ISS who were treated according to two protocol s in comparison to untreated historical controls . In study 1 ( n = 24 ) , all patients were treated with 14 IU ( 4.6 mg)/m(2 ) body surface x wk in the first year ; thereafter the dosage was doubled if the growth response was insufficient . In study 2 ( n = 34 ) , patients were r and omized into three arms : 18 IU ( 6 mg)/m(2 ) x wk ; 27 IU ( 9 mg)/m(2 ) x wk ; and 18 IU/m(2 ) x wk in the first year , followed by 27 IU/m(2 ) x wk thereafter .  Observed or estimated FH was available for 53 patients . Thirty-four untreated controls from the same centers were available for comparison . Mean FH SD score in GH-treated children was -2.1 , vs. -2.4 in controls ( -2.4 ) ( NS ) , but height SD score gain ( 1.3 vs. 0.7 ) and the difference between FH and predicted adult height ( 4.0 vs. 0.8 cm ) were significantly greater . The growth response on an initial dosage of 27 IU/m(2 ) x wk ( 6.9 cm ) was significantly better than on other regimens ( 2.8 cm ) . We conclude that a GH dosage of 27 IU ( 9 mg)/m(2 ) x wk to prepubertal children with ISS leads to a mean FH gain of approximately 7 cm , whereas regimens starting on lower dosages are less efficacious
For height outcome , articles were limited to studies reporting adult height and to systematic review s. FINDINGS Recombinant human growth hormone therapy of children with idiopathic short stature increases height in some children .
The cost-benefit ratio is controversial .
AND RELEVANCE Growth hormone treatment may be considered in some children with idiopathic short stature
IMPORTANCE Approximately 2 % of children are defined as having short stature .
Deciding when to pursue recombinant human growth hormone therapy to increase adult height is controversial .
OBJECTIVE To review the management of children with idiopathic short stature , including diagnostic evaluation and therapeutic options .