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In Reply. —
We tried to summarize the complexity of current controversies about the diagnosis of growth hormone deficiency and the treatment of non-growth hormone—deficient short stature. The points raised by Dr Rotenstein further illustrate this complexity, and we welcome the opportunity to clarify these issues.Dr Rotenstein raises the question of growth hormone response to growth hormone releasing factor in the diagnosis of growth hormone deficiency. However, the classic definition of growth hormone deficiency does not involve assessment of the growth hormone secretory response to growth hormone releasing factor. The rise in growth hormone levels in some growth hormone—deficient children following administration of growth hormone releasing factor is a separate issue and suggests that the etiology of growth hormone deficiency in many children is actually deficiency of growth hormone releasing factor.We agree that the question of growth hormone treatment for very short non—growth hormone—deficient children who have marginal
Cuttler L, Lantos J, Siegler M. Diagnosis of Growth Hormone Deficiency and the Treatment of Short Stature-Reply. JAMA. 1989;262(1):30–31. doi:10.1001/jama.1989.03430010042018
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