{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:59:12Z","timestamp":1747148352576,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T00:00:00Z","timestamp":1713571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>The ketogenic diet (KD) can have a negative impact on the linear growth and body composition of children. The aims of this study were to review two centers' experience with children who developed height deceleration on the KD and determine if the height deceleration was secondary to growth hormone deficiency (GHD), and if growth hormone therapy (GHT) would be effective and safe (not altering ketosis or seizure frequency). Retrospective chart reviews were performed on patients with KD referred to Endocrinology between 2013 and 2018. Seventeen children were identified. Data reviewed included: demographics, growth velocity, KD ratio, protein\/calorie intake, lab results, GH dosage, Tanner stage, and seizure frequency, and endocrine recommendations. Descriptive statistics were performed. Of the 17 children referred to the Endocrine Division, seven children were growth hormone deficient and began GHT. Data were provided for six patients (2 males, 4 females; age 2\u20137\u2009years at the start of KD) on the KD for &gt;6\u2009years and on GHT for &gt;4\u2009years. Growth for all patients stabilized or increased. IGF\u20101 <jats:italic>z<\/jats:italic>\u2010scores normalized. GHT did not affect seizure frequency or ketosis. GHT in those with GHD can be an appropriate option allowing better growth while still maintaining ketogenic therapy and seizure control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>The KD can be an effective treatment for difficult\u2010to\u2010control epilepsy and some disorders of carbohydrate metabolism. The KD can adversely affect the linear growth (height) of children. This case series reviewed six patients who had slow linear growth. It was found that all six children had growth hormone deficiency, grew better with growth hormone treatments, and that their seizures and ketone levels were not affected.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12942","type":"journal-article","created":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T11:24:28Z","timestamp":1713612268000},"page":"1096-1102","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis and treatment of growth hormone deficiency in children on the ketogenic diet: A case series"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1664-1309","authenticated-orcid":false,"given":"Sue","family":"Groveman","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3741-025X","authenticated-orcid":false,"given":"Joerg","family":"Klepper","sequence":"additional","affiliation":[{"name":"Children's Hospital Aschaffenburg\u2010Alzenau  Aschaffenburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus\u2010Peter","family":"Liesenk\u00f6tter","sequence":"additional","affiliation":[{"name":"Facharzt f\u00fcr Kinder\u2010 und Jugendmedizin, Endokrinologikum  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adda","family":"Grimberg","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Pediatrics, Children's Hospital of Philadelphia Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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Christina","family":"Bergqvist","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Neurology and Pediatrics, Children's Hospital of Philadelphia Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2008.01870.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2002.tb00769.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2008.01769.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2012.05.019"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16413-1"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000452150"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0026-4946.20.05821-1"},{"issue":"2","key":"e_1_2_10_9_1","first-page":"499","article-title":"Insulin\u2010like growth factor\u2010I is a marker for the nutritional state","volume":"13","author":"Hawkes CP","year":"2015","journal-title":"Pediatr Endocrinol Rev"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2021-0045"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000502231"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114512002577"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2410"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.2196\/16204"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(94)70117-2"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12225"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2005.02.009"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(99)00387-9"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2011.05.012"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2008.02064.x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/133.11.4010S"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1993.372"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzy079"}],"container-title":["Epilepsia Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.12942","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T12:09:18Z","timestamp":1717416558000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi4.12942"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,20]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/epi4.12942"],"URL":"https:\/\/doi.org\/10.1002\/epi4.12942","archive":["Portico"],"relation":{},"ISSN":["2470-9239","2470-9239"],"issn-type":[{"type":"print","value":"2470-9239"},{"type":"electronic","value":"2470-9239"}],"subject":[],"published":{"date-parts":[[2024,4,20]]},"assertion":[{"value":"2023-10-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}