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December 18, 1996

Use of Growth Hormone for Non—Growth Hormone Deficient Children-Reply

Author Affiliations

All Children's Hospital St Petersburg, Fla

JAMA. 1996;276(23):1878. doi:10.1001/jama.1996.03540230028028

In Reply.  —The comments of Dr Diller are acknowledged. I also appreciate Dr Voron's letter. Actually, because of space constraints in writing the Editorial, I combined information from 2 references and omitted the specific reference, another study by Wit et al,1 to which Voron actually is referring. In that multicenter study from 5 Dutch pediatric endocrine centers, a limited number (n=22) of prepubertal short stature children were evaluated. Voron's point is well taken; however, in the author's own words,A surprising finding was that the bone age delay, which would be expected to correlate positively with the degree of growth hormone insufficiency and therefore with the gain in final height, was negatively related to the final outcome. This is probably caused by a relatively large bone age advance in children with a large initial bone age delay, thereby limiting the effect on final height.That provides more detail to the statement