Delayed diagnosis of congenital hypopituitarism associated with low socio-economic status and/or migration

Abstract

• Check the metadata sheet to make sure that the header information, especially author names and the corresponding affiliations are correctly shown. • Check the questions that may have arisen during copy editing and insert your answers/corrections. • Check that the text is complete and that all figures, tables and their legends are included. Also check the accuracy of special characters, equations, and electronic supplementary material if applicable. If necessary refer to the Edited manuscript. • The publication of inaccurate data such as dosages and units can have serious consequences. Please take particular care that all such details are correct. • Please do not make changes that involve only matters of style. We have generally introduced forms that follow the journal's style. Substantial changes in content, e.g., new results, corrected values, title and authorship are not allowed without the approval of the responsible editor. In such a case, please contact the Editorial Office and return his/her consent together with the proof. • If we do not receive your corrections within 48 hours, we will send you a reminder. Please note Your article will be published Online First approximately one week after receipt of your corrected proofs. This is the official first publication citable with the DOI. Further changes are, therefore, not possible.

Characteristics of paediatric hypopituitarism patients in Latvia: a single-centre 25-year retrospective study

“…It is plausible that the first signs and symptoms were missed or underestimated due to insufficient knowledge and/or understanding of growth restriction disorders and their incidence. The median age of diagnosis is the lowest in the PH group compared to the other groups (3 years and 4 months), which could be explained by the fact that these children suffer from severe congenital hypopituitarism, and [17]. Nevertheless, current available scientific literature regarding the average age of diagnosis is heterogenous, but the key fact about diagnostic process is clear: the sooner the diagnosis is made, the sooner effective treatment can be started and a positive outcome achieved.…”

“…Testing IGF-1 has some advantages (IGF-system peptides are stable during the day, and it is used as a long-term biomarker during GH replacement therapy), but its level in blood is also dependent on many other factors, for instance, nutritional status, other diseases (diabetes, hypothyroidism, renal failure), and other conditions could be the reason for low IGF-1. We emphasize that interpretation of all diagnostic methods is valuable for a correct final diagnosis, as well as IGF-1 [7,[14][15][16][17][18][19].…”

“…Boros et al . in 2019 proposed that patients diagnosed with the disease after the age of 10 years should considered as very late for the diagnosis of the disease; therefore, 40% of our study population could be classified as very late for final diagnosis [ 17 ]. Nevertheless, current available scientific literature regarding the average age of diagnosis is heterogenous, but the key fact about diagnostic process is clear: the sooner the diagnosis is made, the sooner effective treatment can be started and a positive outcome achieved.…”

“…In these patients, the median difference between CA and BA was 16 months. The age difference between the 3 subgroups was 14 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) months in the IGHD group, 19 (12-26.5) months in the MPHD group, and 25.5 (22.5-27.5) months in the PH group.…”

Delayed Diagnosis of Congenital Combined Pituitary Hormone Deficiency including Severe Growth Hormone Deficiency in Children with Persistent Neonatal Hypoglycemia—Case Reports and Review

“…Boros et al [ 16 ] described seven patients with PSIS, diagnosed at the age from 10.5 to 27.0 years, with normal perinatal history, in whom the first problem was short stature, followed by the lack of spontaneous pubertal development in older patients. The authors pointed out the fact that all these patients were either migrants (five cases) or from families with low socio-economic status (two cases).…”