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 |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Mcgeoch, Rabbi Steph and Perry, Dr Colin and Mason, Dr Avril and Shaikh, Dr Mohammed Guftar and Ahmed, Professor Syed Faisal and Donaldson, Dr Malcolm |
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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