Natural History of Growth Hormone Deficiency in a Pediatric Cohort

Deillon, Eva; Hauschild, Michael Zwicky; Faouzi, Mohamed; Stoppa-Vaucher, Sophie; Elowe-Gruau, Églantine; Dwyer, Andrew A.; Theintz, G; Dubuis, Jean-Michel; Mullis, Primus-Eugen; Pitteloud, Nelly; Phan-Hug, Franziska

doi:10.1159/000369392

Cited by 13 publications

(3 citation statements)

References 42 publications

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“…More than half of the patients (n = 13/24) had normal GH secretion after treatment was discontinued. This finding is similar to that of a previous study that reported that 56% of the patients had normal GH secretion after reaching FAH [ 27 ]. In contrast, patients with MPHD are likely to have persistent GHD compared with those with isolated GHD; this finding is similar to that reported by Thomas et al [ 21 ], who demonstrated that 15% of the isolated GHD cases were persistent GHD cases.…”

Section: Discussionsupporting

confidence: 92%

Optimal final adult height achieved by low-dose recombinant human growth hormone therapy

Saengkaew,

Aroonparkmongkol,

Wacharasindhu

2024

Asian Biomedicine

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Background Thailand has been administering the recombinant human growth hormone (rhGH) treatment for >20 years. Due to limited resources being available, efforts have been directed toward utilizing rhGH at the lowest feasible dose. However, there is currently a lack of evidence in terms of the efficacy and outcomes. Objective To evaluate the auxological outcomes of growth hormone (GH) treatment and the GH secretion ability after reaching final adult height (FAH) and discontinuing rhGH. Methods Data of 40 patients were retrospectively reviewed. The clinical characteristics, auxological data, and results of biochemical and endocrine investigations before and during rhGH treatment were evaluated. In addition, GH retesting was performed in 24 patients using the insulin tolerance test. Results Twenty patients (50%) had complete growth hormone deficiency (GHD), defined as peak stimulated GH level <5 ng/mL, and the remaining patients had partial GHD. Most patients were male (n = 25, 62.5%). The mean age at which rhGH was initiated was 8.9 years. Patients with partial GHD received a higher dose of rhGH than those with complete GHD (30.9 µg/kg/d vs. 26.2 µg/kg/d, P = 0.02). Patients with complete and partial GHD reached FAH at height standard deviation scores (SDSs) of −0.65 and −1.47, respectively. The factors associated with obtaining a good clinical response in terms of height gain included peak-stimulated GH level, age of puberty, and age of discontinuing rhGH. After completing the rhGH treatment, 13 of the 24 patients showed normal GH secretion. Patients with multiple pituitary hormone deficiency (MPHD) were likely to have persistent GHD through adulthood (n = 8, 88.9%). Conclusion This study has demonstrated that the use of low-dose rhGH could result in healthy populations achieving optimal FAHs. Patients with MPHD might not require retesting as they were likely to have persistent GHD. The results obtained in this research highlight the benefits of the treatment. This treatment can be applied in resource-limited countries.

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Section: Discussionsupporting

confidence: 92%

Optimal final adult height achieved by low-dose recombinant human growth hormone therapy

Saengkaew,

Aroonparkmongkol,

Wacharasindhu

2024

Asian Biomedicine

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“…Re-evaluation of the GH status has shown that GHD is permanent in patients with CPHD, acquired hypothalamic-pituitary lesions, pituitary hypoplasia, pituitary stalk agenesis and posterior pituitary ectopia. On the contrary, a high proportion of children with isolated GHD and no pituitary abnormalities show a different percentage of normalization of GH secretion, ranging from 12.5% to 95% [98][99][100][101]. Our recently unpublished results showed that, at the time of re-testing, 82.1% of severe GHD and 82.4% of partial GHD patients showed transient GHD.…”

Section: Gh Therapy In Transition Agementioning

confidence: 75%

Growth Hormone Deficiency: Diagnosis and Therapy in Children

Boiocchi¹,

Meazza²

2016

Restricted Growth - Clinical, Genetic and Molecular Aspects

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Short stature has been defined as a height below the 2 standard deviation for age, sex and ethnicity. Growth hormone deficiency (GHD) represents a condition characterized by reduced GH secretion, isolated or associated with other pituitary hormone deficiencies. In a child with short stature and growth deceleration, after the exclusion of other causes of growth failure, the diagnosis of GHD has to be confirmed by measurement of GH secretion after at least two stimulation tests. Patients with GHD should be treated with rhGH as soon as possible, to obtain normalization of growth and normal final height. The catch-up growth in response to rhGH therapy is maximal during the first years and could be affected by many variables, such as birth-weight, age and height at start of treatment and of puberty, and duration of treatment. Overall, rhGH is believed to be safe and significant side-effects in children are very rare, including benign intracranial hypertension, hyperglycaemia, arthralgia and myalgia. Patients with childhood onset GHD are usually retested in late adolescence to confirm the GHD persistence and to continue of GH therapy. In conclusion, the present chapter provides useful and updated information about the diagnosis, treatment and follow-up of children with GHD.

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“…Treatment with somatropin has been associated with improvement in metrics of final height, depression, behavioral issues, and psychosocial evaluations. [7][8][9] In a majority of cases, patients may not require somatropin therapy into adulthood 10 ; however, some patients will require treatment into adulthood. 2 Optimal outcomes in final adult height from somatropin treatment are usually achieved when patients are started early, before age 9 years, 11 and are highly adherent to treatment, defined in Cutfield et al as missing no more than 1 dose per week.…”

Section: What This Study Addsmentioning

confidence: 99%