When are we diagnosing growth hormone deficiency?

Area of Science:

• Pediatrics
• Endocrinology
• Growth Disorders

Background:

• Growth hormone deficiency (GHD) affects children's height and development.
• Treatment initiation and outcomes for GHD have evolved over time.
• Specific GHD causes include isolated deficiency, hypothalamopituitary tumors, and cranial irradiation.

Purpose of the Study:

• To retrospectively analyze height and age at presentation for children starting growth hormone (GH) treatment.
• To evaluate the effectiveness of GH therapy in different pediatric GHD populations.
• To compare current treatment outcomes with historical data.

Main Methods:

• Retrospective analysis of 458 children treated with GH from January 1980 to June 1984.
• Categorization of patients based on GHD etiology: isolated GHD, hypothalamopituitary tumors, and cranial irradiation.
• Comparison of height standard deviation scores (SDS) before and after treatment, and against historical cohorts.

Main Results:

• Children with isolated GHD (n=309) had a mean age of 10 years and a mean height SDS of -3.73, showing improvement with treatment.
• Patients with hypothalamopituitary tumors (n=109) started GH treatment 3.3 years post-diagnosis with a mean height SDS of -2.42, demonstrating considerable improvement.
• Children with GHD secondary to cranial irradiation (n=42) had a mean height SDS of -2.45, comparable to historical UK data.

Conclusions:

• Growth hormone therapy significantly improves height SDS in children with various forms of GHD.
• Earlier diagnosis of GHD may be facilitated by routine height screening at school entry.
• Regular monitoring of height velocity in children treated for cranial irradiation is crucial for timely intervention.