Endocrine Abstracts

Objective: To audit GH deficiency in the transition service at our institution.

Methods: Patients between 19–25 years old were identified from the database of patients having GH replacement. Data were obtained from case notes and electronic records.

Results: Twenty-four patients in the transition service were identified to be GH deficient, 13 female and 11 male. 14/24 had CNS or pituitary tumours treated in childhood, 11 having been treated with radiotherapy, six having undergone chemotherapy and nine undergoing surgery. 6/24 had idiopathic/congenital hypopituitarism, and four had RT as part of treatment of leukaemia.

Of 16/24 patients had their GH axis retested on completion of linear growth. GH doses for females was 0.41 (range 0.3–0.8 mg/day) and for males 0.39 (0.2–0.8 mg/day). 18/24 have central hypothyroidism, 18/24 required sex hormone replacement (12/13 females on oestrogen replacement and 6/11 males requiring testosterone replacement), 11/24 were ACTH deficient, and 4 patients had cranial D.I. 1 patient had a diagnosis of isolated GH deficiency.

IGF1 were in the age and gender related normal range in 19/24 patients. However 5 had an IGF1 of <10 ng/l suggestive of poor compliance/concordance.

Metabolic indices: All patients were normotensive and had normal HbA1c. 14/24 patients had a BMI >25 kg/m². 15/24 patients had a cholesterol >5 mmol/l, with 6 of these having a cholesterol >6 mmol/l. This was not related to weight or any other anterior pituitary hormone replacement.

Conclusions: The majority of patients in this cohort are survivors of childhood malignancies. Hypercholesterolemia was an unexpected finding, aetiology of which is unclear. Another unexpected finding was the lack of difference in GH dose between female and male patients, especially as the majority of females were taking oestrogen replacement.