The aim of our prospective case-control study was to evaluate long-term effects of GH replacement
therapy on erythrocytes parameters, leukocytes, and platelets numbers in a large cohort of children with
isolated GH deficiency (GHD).
Hemoglobin (Hb) concentration, hematocrit (Hct), mean corpuscular volume, mean corpuscular hemoglobin, red cell distribution width, number of erythrocytes, leukocytes, neutrophils, lymphocytes, monocytes and platelets,
ferritin, and
C-reactive protein were evaluated in 85 children with isolated GHD (10.20 ± 3.50 years) before and annually during the first 5 years of GH replacement
therapy and in 85 healthy children age and sex comparable to patients during 5 years of follow-up. Compared with controls, GHD children at study entry showed lower Hb (-1.18 ± 0.87 vs. -0.40 ± 0.90 SDS, p < 0.0001), red cells number (-0.24 ± 0.81 vs. 0.25 ± 1.14 SDS, p < 0.0001), and Hct (-1.18 ± 0.86 vs. -0.68 ± 0.99 SDS, p < 0.0001). Twelve GHD patients (14 %) showed a normocytic
anemia. GH
therapy was associated with a significant increase in Hb, Hct, and red cells number which became all comparable to controls within the first 2 years of treatment. Moreover,
hemoglobin levels normalized in all anemic GHD patients after 5 years of
therapy. No difference between patients and controls was found in leukocytes and platelets numbers neither at baseline nor during the study. GHD in childhood is associated with an impairment of erythropoiesis which causes a normocytic
anemia in a considerable percentage of patients. GH replacement
therapy exerts a beneficial effect leading to a significant increase of erythrocytes parameters and recovery from
anemia. Neither GHD nor GH replacement treatment exerts effects on leukocytes or platelets numbers.