More guidance on growth hormone deficiency

Ayling, Ruth M

doi:10.1136/jcp.2003.8029

“…This is justified by the study of growth retardation by Nath et al where PEM and chronic anemia resulted in more than 60% of cases of SS [42]. In various endocrine causes of growth failure like GHD including hypopituitarism, primary hypothyroidism, precocious puberty, and other rare congenital genetic disorders (e.g., NS, SS homeobox-containing gene deficiency (SHOX-D), and TS), there is a failure to gain height but the weight continues to be within normal centiles [43, 44]. …”

Section: Resultsmentioning

confidence: 99%

Challenges in the Diagnosis and Management of Growth Hormone Deficiency in India

John¹,

Koledova

²

,

Kumar

³

et al. 2016

International Journal of Endocrinology

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In clinical practice, every year approximately 150,000 children are referred with short stature (SS) based on a cut-off of fifth percentile. The most important endocrine and treatable cause of SS is growth hormone deficiency (GHD). The lack of reliable data on the prevalence of GHD in India limits estimation of the magnitude of this problem. The diagnosis and treatment of GHD are hurdled with various challenges, restricting the availability of growth hormone (GH) therapy to only a very limited segment of the children in India. This review will firstly summarize the gaps and challenges in diagnosis and treatment of GHD based on literature analysis. Subsequently, it presents suggestions from the members at advisory board meetings to overcome these challenges. The advisory board suggested that early initiation of the therapy could better the chances of achieving final adult height within the normal range for the population. Education and awareness about growth disorders among parents, regular training for physicians, and more emphasis on using the Indian growth charts for growth monitoring would help improve the diagnosis and treatment of children with GHD. Availability of an easy-to-use therapy delivery system could also be beneficial in improving adherence and achieving satisfactory outcomes.

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“…Accurate diagnosis of GHD is crucial to the identification of children who are at risk of having or developing other pituitary hormone deficiencies, in particular adrenal insufficiency [ 12 ]. Current guidelines include short stature with poor growth velocity, low GH peak following GHST, low serum IGF-1 and IGFBP-3, and delayed bone age as typical features of GHD, with GHST remaining the gold standard [ 2 – 5 ]. The combination of poor height velocity and low IGF-1 has also been shown to correlate well with GHD [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…To develop the survey content, we reviewed the most recent guidelines from the American Association of Clinical Endocrinologists (AACE) [ 2 ], the Endocrine Society (ES) [ 3 ], the Growth Hormone Research Society (GHRS) [ 4 ], and the Lawson Wilkins Pediatric Endocrine Society (LWPES) [ 5 ] and extracted specific recommendations for diagnosis and treatment. In addition, a Medline search was conducted on the terms “growth hormone,” “growth hormone deficiency,” “Turner syndrome,” “craniopharyngioma,” and “Prader-Willi syndrome.” The search was limited to papers published since the most recent updates of the guidelines (2003–2006).…”

Section: Methodsmentioning

confidence: 99%

Consensus and Discordance in the Management of Growth Hormone-Treated Patients: Results of a Knowledge, Attitudes, Beliefs, and Practices Survey

Miller

¹

,

Shulman

²

,

Shillington

³

et al. 2010

International Journal of Pediatric Endocrinology

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Our purpose was to determine pediatric endocrinologists' knowledge, attitudes, beliefs, and practices (KABPs) regarding recombinant human growth hormone (rhGH) treatment, examine care-related attitude consensus or discordance, and identify evidence-based practice gaps. We developed a survey for National Cooperative Growth Study (NCGS) investigators (N = 711) to elicit their KABPs regarding GH stimulation testing as a diagnostic tool, IGF-1 monitoring for safety and dosing guidance, and pubertal dosing. Responses were compared with NCGS data from the last 20 years. Comparison between survey responses and NCGS data revealed potential discrepancies between expressed opinions and actual practice. In conclusion, this KABP survey, combined with NCGS data, suggests changes over time in diagnostic and rhGH-related therapeutic practices. Variability and inconsistency exist between the survey responses and practice trends over time as reflected in the NCGS database. Further study is necessary to provide evidence to guide rhGH treatment decisions.

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“…Accurate diagnosis of GHD is crucial to the identification of children who are at risk of having or developing other pituitary hormone deficiencies, in particular adrenal insufficiency [12]. Current guidelines include short stature with poor growth velocity, low GH peak following GHST, low serum IGF-1 and IGFBP-3, and delayed bone age as typical features of GHD, with GHST remaining the gold standard [2–5]. The combination of poor height velocity and low IGF-1 has also been shown to correlate well with GHD [13].…”

Section: Discussionmentioning

confidence: 99%

“…To develop the survey content, we reviewed the most recent guidelines from the American Association of Clinical Endocrinologists (AACE) [2], the Endocrine Society (ES) [3], the Growth Hormone Research Society (GHRS) [4], and the Lawson Wilkins Pediatric Endocrine Society (LWPES) [5] and extracted specific recommendations for diagnosis and treatment. In addition, a Medline search was conducted on the terms “growth hormone,” “growth hormone deficiency,” “Turner syndrome,” “craniopharyngioma,” and “Prader-Willi syndrome.” The search was limited to papers published since the most recent updates of the guidelines (2003–2006).…”

Section: Methodsmentioning

confidence: 99%

Consensus and Discordance in the Management of Growth Hormone-Treated Patients: Results of a Knowledge, Attitudes, Beliefs, and Practices Survey

Miller¹,

Shulman²,

Shillington³

et al. 2010

International Journal of Pediatric Endocrinology

View full text Add to dashboard Cite

Our purpose was to determine pediatric endocrinologists' knowledge, attitudes, beliefs, and practices (KABPs) regarding recombinant human growth hormone (rhGH) treatment, examine care-related attitude consensus or discordance, and identify evidence-based practice gaps. We developed a survey for National Cooperative Growth Study (NCGS) investigators (N = 711) to elicit their KABPs regarding GH stimulation testing as a diagnostic tool, IGF-1 monitoring for safety and dosing guidance, and pubertal dosing. Responses were compared with NCGS data from the last 20 years. Comparison between survey responses and NCGS data revealed potential discrepancies between expressed opinions and actual practice. In conclusion, this KABP survey, combined with NCGS data, suggests changes over time in diagnostic and rhGH-related therapeutic practices. Variability and inconsistency exist between the survey responses and practice trends over time as reflected in the NCGS database. Further study is necessary to provide evidence to guide rhGH treatment decisions.

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More guidance on growth hormone deficiency

Cited by 8 publications

References 40 publications

Challenges in the Diagnosis and Management of Growth Hormone Deficiency in India

Challenges in the Diagnosis and Management of Growth Hormone Deficiency in India

Consensus and Discordance in the Management of Growth Hormone-Treated Patients: Results of a Knowledge, Attitudes, Beliefs, and Practices Survey

Consensus and Discordance in the Management of Growth Hormone-Treated Patients: Results of a Knowledge, Attitudes, Beliefs, and Practices Survey

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