Growth Suppression by Glucocorticoids

Long-term treatment with glucocorticoids (GC) frequently results in growth failure in children. While most disorders requiring such treatment (e.g., organ transplantation, inflammatory bowel disease, rheumatoid diseases, severe asthma) are relatively rare, the expanding use of inhaled GC preparations for treatment of mild-to-moderate asthma has greatly increased the numbers of children chronically exposed to exogenous GC. This chapter reviews the mechanisms of GC effects on growth, current information about effects of inhaled corticosteroids (ICS) on growth of children with asthma, and preliminary investigations into reversal of GC-induced growth failure with human growth hormone (GH) therapy.