Who should receive hormone therapy?

Exceedingly short children who fail to meet the technical definition of growth hormone deficiency still can benefit from treatment with a synthetic form of the hormone, according to a long-term study conducted at 10 major universities. The results suggest that the medical criterion for deciding who will get treated is arbitrary, explains the study's principal author, Raymond Hintz, professor of pediatric endocrinology at Stanford University School of Medicine. "We are dividing short children into a box, where on one side of the line you have growth hormone deficiency and on the other side you don't. [The study] is saying that the line we draw . . . isn't always the right line. Some patients beyond that line may benefit from treatment."

Insufficient production of growth hormone from the pituitary gland results in severely short stature. Growth hormone deficiency affects about one in 3,480 children nationwide. Traditionally, it has been defined as a maximum, drug-stimulated secretion of less than 10 nanograms of the hormone per milliliter of blood, and children meeting that criterion have been considered eligible for treatment with synthetic hormone. The study found that such treatment also can help severely short youngsters who produce more than the defining...