It’s not about the height

Allen, TRENDS in Endo & Metab Book Review of Eiholzer book (PWS. Effects of GH Treatment), May/June 2002 

Urs Eiholzer, a prominent investigator of PWS, has recently written a book on PWS which provides an overview of PWS with a special emphasis on GH treatment  (PWS. Effects of GH Treatment, Karger, 2001, ISBN: 3805572565). The book was recently reviewed favorably in TRENDS in Endocrinology and Metabolism. 

In the book, Eiholzer highlights his impressive 5-year follow-up study of 35 individuals with PWS who were receiving GH treatment. He reports the well-known improvements in growth rate, fat composition, motor development, physical ability and body proportion.

One of the primary issues Eiholzer tackles is the question of whether individuals with PWS are truly lacking in GH, or if they just appear to be lacking GH because obesity can cause GH to decrease. Eiholzer argues that those with PWS indeed have GH deficiency unrelated to their obesity and describes impressive evidence of fasting insulin levels that do not vary depending on whether the subject was obese or not. In addition, he discusses how these levels are very similar to levels of non-PWS obese subjects, providing further support for his argument that those with PWS indeed display a decrease in GH that is unrelated to their weight.

The reviewer notes that one of the parts of the book that is the most fascinating is the photographic documentation of individuals receiving GH treatment. What the reviewer feels was lacking in the book was a discussion of the ethical issues that arise from GH treatment in PWS, including the initial incorrect belief that those with mental disabilities would not benefit from such treatment and were not “entitled” to GH treatment. This is particularly fascinating especially since GH administration in PWS has taught the medical field a tremendous amount about the impressive non-growth benefits of this treatment. 

Overall, the reviewer feels this is a welcome addition to the literature on PWS and GH administration. The fact that it comes from such a respected specialist makes it a very exciting book especially for geneticists and endocrinologists, but can also be helpful for anyone interested in PWS.

 edited: 06/10/2009