I. What types of dwarfism can be treated with growth hormone? According to the drug description, growth hormone is most commonly used and most indicated for the treatment of patients with growth hormone deficiency, which is the most effective type of disorder for which it is used. The next most common indications are non-growth hormone deficiencies, including idiopathic dwarfism, Turner’s syndrome due to growth hormone deficiency or non-deficiency, etc. II. What kind of therapeutic effect does growth hormone have? Xiaoling Fu, Department of Pediatrics, Guizhou Provincial People’s Hospital Growth hormone has two main effects. The first is to promote growth, and for childhood, it is mainly to help it grow taller. Secondly, growth hormone can affect sugar and lipid metabolism. For example, in patients with severe growth hormone deficiency, blood lipids will be elevated, and a large amount of fat will accumulate in the abdomen and chest, affecting the appearance. After the drug is administered, the blood lipids will return to normal, the fat accumulation in the abdomen will gradually disappear, and the person will become slimmer and more muscular. Therefore, patients with growth hormone deficiency are recommended to use growth hormone in small doses under the guidance of a doctor, even if they have no need to grow taller as adults. This is beneficial for improving metabolism and lifelong health. For children with non-growth hormone deficiency, the purpose of medication is to promote their growth. Generally, the medication is discontinued when the height reaches within the normal range of height. Treatment is not medically recommended for those who are in the normal short range of height but require height increase. 4 common types of adverse reactions i. What are the side effects or adverse reactions that can occur with the use of growth hormone? In general, if the drug is administered in strict accordance with the drug instructions and indications, growth hormone is a relatively safe drug with few side effects or adverse reactions. If side effects or adverse reactions occur after the drug is administered, they are mainly related to the dose of the drug used. In a normal human body, growth hormone is naturally secreted by the body and is sufficient for physical growth. For the treatment of growth hormone deficiency, we use small dose replacement therapy, that is, we replace the normal physiological amount of the body with drugs by the amount of deficiency. These doses are basically safe. If used for non-growth hormone deficiencies, such as idiopathic dwarfism and Turner syndrome, the side effects will become apparent when the dose is relatively high or the duration of use is longer. The most common side effect of growth hormone is an increase in blood sugar. Some diseases that cause excess growth hormone in the body, such as gigantism and lipodystrophy, have abnormalities in glucose metabolism, leading to elevated blood sugar. When using growth hormone replacement therapy, if the drug dose is high, it may also cause abnormal glucose metabolism and in severe cases, type 2 diabetes may develop. However, there are individual differences and may be related to family history. In the past, the second common side effect was local skin reactions, such as local itching, redness and swelling, mostly seen with some early drugs. But nowadays, as the purity of growth hormone preparations is getting higher and higher, the quality of domestic preparations is also getting better. These local reactions are almost gone. Some children may experience local pain after injection, which is mainly related to psychological factors and can be tolerated. The third common side effect is pseudotumor cerebri. The child will experience headaches and increased cranial pressure after the injection. These symptoms will disappear when the drug is discontinued. For this condition, parents should be reminded to take their children for regular review and to go to the hospital in case of discomfort. The fourth side effect is joint slippage. This is a very rare condition, mainly related to the accelerated growth of the child after the use of the drug. Parents are more concerned and pay more attention to the problem, which also includes that growth hormone will promote cell proliferation and division, which may induce tumor or recurrence. However, from the use of our hospital and the large amount of international statistics, the incidence of tumors does not increase significantly due to the use of growth hormone. In addition, some children may experience pain in their limbs due to accelerated growth, especially occurring in the afternoon. We call this growing pains and it is a normal condition. We have also encountered some children in our clinic who were found to have some scoliosis in their spine after using the drug. Our analysis revealed that these children had a less obvious congenital deformity of the spine itself, scoliosis, before the growth hormone injection. However, the doctors did not examine them carefully before treatment. As the height increased, the problem came to the fore and the parents noticed it and assumed it was a side effect of the drug. In fact, the two are not related. Are there any individual differences in the possible adverse effects and side effects of growth hormone? Yes. All drug reactions are related first to the drug itself, and then to individual differences. We require doctors to keep good records before using growth hormone, to carefully check whether the child has scoliosis, etc., and to do basic routine biochemical tests. Also, considering the fact that groups and individuals are different and everyone is at risk of developing tumors, it is important to give the child a proper examination and understand his or her family history of the disease.