An audit of the management of childhood-onset growth hormone deficiency during young adulthood in Scotland

Ahmid, M. et al. (2016) An audit of the management of childhood-onset growth hormone deficiency during young adulthood in Scotland. International Journal of Pediatric Endocrinology, 2016, 6. (doi:10.1186/s13633-016-0024-8) (PMID:6985190) (PMCID:PMC479349)

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Abstract

Background Adolescents with childhood onset growth hormone deficiency (CO-GHD) require re-evaluation of their growth hormone (GH) axis on attainment of final height to determine eligibility for adult GH therapy (rhGH). Aim: Retrospective multicentre review of management of young adults with CO-GHD in four paediatric centres in Scotland during transition. Patients: Medical records of 130 eligible CO-GHD adolescents (78 males), who attained final height between 2005 and 2013 were reviewed. Median (range) age at initial diagnosis of CO-GHD was 10.7 years (0.1–16.4) with a stimulated GH peak of 2.3 μg/l (0.1–6.5). Median age at initiation of rhGH was 10.8 years (0.4–17.0). Results: Of the 130 CO-GHD adolescents, 74/130(57 %) had GH axis re-evaluation by stimulation tests /IGF-1 measurements. Of those, 61/74 (82 %) remained GHD with 51/74 (69 %) restarting adult rhGH. Predictors of persistent GHD included an organic hypothalamic-pituitary disorder and multiple pituitary hormone deficiencies (MPHD). Of the remaining 56/130 (43 %) patients who were not re-tested, 34/56 (61 %) were transferred to adult services on rhGH without biochemical retesting and 32/34 of these had MPHD. The proportion of adults who were offered rhGH without biochemical re-testing in the four centres ranged between 10 and 50 % of their total cohort. Conclusions: A substantial proportion of adults with CO-GHD remain GHD, particularly those with MPHD and most opt for treatment with rhGH. Despite clinical guidelines, there is significant variation in the management of CO-GHD in young adulthood across Scotland.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mason, Dr Avril and Donaldson, Dr Malcolm and Perry, Dr Colin and Mcgeoch, Rabbi Stephanie and Shaikh, Dr Mohammed Guftar and Ahmed, Professor Syed Faisal
Authors: Ahmid, M., Fisher, V., Graveling, A. J., McGeoch, S., McNeil, E., Bevan, J. S., Bath, L., Donaldson, M., Leese, G., Mason, A., Perry, C. G., Zammitt, N. N., Ahmed, S. F., and Shaikh, M. G.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:International Journal of Pediatric Endocrinology
Publisher:BioMed Central
ISSN:1687-9856
ISSN (Online):1687-985
Copyright Holders:Copyright © 2016 Ahmid et al.
First Published:First published in International Journal of Pediatric Endocrinology
Publisher Policy:Reproduced under a Creative Commons License

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