Endocrine Abstracts

Background: GH therapy in adolescents with childhood onset GH deficiency (CO-GHD) is often necessary to prevent adult GHD syndrome and requires a re-evaluation of the GH axis on attainment of final height. Not all individuals with CO-GHD remain GH deficient and re-evaluation is required to confirm or refute adult GHD.

Aim: Review the care received by young adults diagnosed with CO-GHD.

Design: Retrospective review of young adults with CO-GHD patients between 2005 and 2011 in a single paediatric tertiary centre.

Result: 75 former CO-GHD patients, 48 male: 27 female, with median age 19 year (15–26.2) at time of data collection were reviewed. The etiologies of CO-GHD were: craniopharyngioma and other tumours (n=28), multiple pituitary hormone deficiencies (MPHD) (n=8), isolated GH deficiency (IGHD) (n=14), and other causes (n=25). Median age at diagnosis was 12.5 year (0.25–16.9) with initial GH peak 2.3 μg/l (0.1 – 6.5). Of 75 patients, only 66 were treated with GH at a median age 11.5year (1.2 –17.2), and 41 of those who received GH therapy were later referred to the transition clinic at a median age 17.9 year (16–20.7) for re-assessment the GH axis after withdrawal of GH therapy at a median age 16.4 year (10.6–20) with a median duration of treatment 4.5year (0.3–16.1). Re-evaluation of the GH axis was performed in 41 cases after 0.4 year (0.17–4.3) of GH withdrawal, median repeat GH peak 1.1 μg/l (0.1–7.9) of those 32 who remained GHD only 29 opted to restart GH therapy.

Conclusions: Optimal care of adults with CO-GHD requires a close relationship between paediatric and adult services. A substantial proportion of affected adults continue to have GHD and most opt for GH therapy. There is a need for a study of the current practice of assessment and management of CO-GHD in the UK.