
increased stature
the fact that some patients respond to growth-hormone
administration with linear growth does not indicate growth-hormone
deficiency or hypopituitarism.  yet this appears to
be the main factor that led these authors to assume that
their patients were suffering from hypopituitarism.  the
conclusion that children with growth retardation should be
subjected to a short trial period of treatment with growth
hormone to single out those who are deficient in growth hormone
is therefore of questionable validity.
rather, because of the limited supply of human growth
hormone, it appears that much more stringent criteria for
administration of human growth hormone should be advocated.
every effort should be made to uncover the patients
who might benefit from growth hormone by utilizing reliable
tests of pituitary function and perfecting a suitable growth-hormone
assay.  those who have more than suggestive evidence
of hypopituitarism and growth-hormone deficiency
should then be treated and carefully evaluated for response
after long-term treatment.
