Therapy with recombinant human Growth Hormone (rhGH) is widely available and has been the most important treatment for several growth disorders in childhood since 1985. Scientific attention has been greatly focused on growth disorders directly involving the GH-IGF1 system and other genetic syndromes causing pre and post-natal growth insufficiency. The list of growth factors and genes involved in the complex human growth pathway has been increasing, thank to scientific research.

At the same time, medical progress allowed a better treatment of many well-known chronic diseases affecting children since early age. Short stature in adult life is not the only potential consequence in these children, also the glucose/lipid metabolism and bone-muscle system can result compromised. Long-term complications affect quality of life and psychosocial health in young adult life. Many efforts have been delivered by researchers in getting a better understanding of these mechanism and finding potential solutions. rhGH has been proposed in many pathological conditions to normalize growth and prevent metabolic complications, and long-term safety remains a priority which need a steady surveillance. Paediatricians, and paediatric endocrinologists especially, are of primary importance in the multidisciplinary care of these children. They must face with the growth failure and the long-term complication, in cooperation with the other specialists involved in the care of such chronic diseases. Therefore, there is need for an extensive update on the underling pathogenesis affecting GH-IGF1system, and on the most recent evidence about the potential role of rhGh therapy in promoting growth and prevent complications. Discussion of these medical issues is essential for the caregivers to provide their patients with the most innovative care.

The scope of this proposal is to bring together international experts and offer milestones and new insights on the most updated scientific evidence on chronic disease related growth impairment in children and potential benefit and safety of rhGH therapy.