Endocrine Abstracts

Introduction: Hypopituitarism is a clinical syndrome of deficiency in growth hormone (GHD) production, which can occur isolated or associated with others pituitary defects. GHD has an incidence of 1:4000 to 1:10 000. It may be idiopathic, congenital or acquired.

Purpose: Characterize the paediatric population with GHD followed at the Paediatric Endocrinology Unit of our centre and compare the clinical presentation and treatment response of the patients with an idiopathic form with the ones with isolated and multiple hormonal deficiencies.

Methods: Retrospective observational study with analysis of clinical records of children and adolescents with GHD under treatment with GH in the period from 2012 to 2016. Statistical analyses were performed using SPSS 24.0 for Windows.

Results: The final sample consisted in 49 patients, 61.2% were male. Mean age at the beginning of therapy was 9.7±4 years (0.13–16.92). Mean height z-score at time of diagnosis was −3.16±0.94, corresponding the mean z-score of the target height to −1.24±0.77. The mean delay in bone age was 2.22±1.50 years (0–6.5 years). Two growth hormone stimulation tests (clonidine and L-Dopa) were performed in 69.4% of the cases. Brain MRI showed changes in 42.9% of the cases. Of the 49 patients, 55.1% had an idiopathic GHD, 30.6% isolated deficiency and 14.3% had multiple deficiencies. Mean age at the time of diagnosis was 11.16, 8.84 and 6.57 years in the three groups respectively. Mean treatment duration was 3.92 years (in 14.2% less than 1 year). The z-score variation in the group of idiopathic GHD was 0.99, 1.50 and 2.53 in the group of isolated and multiple deficiencies respectively.

Discussion: As previously described, GHD is more prevalent in males. Comparing the three groups, patients with multiple deficiency are diagnosed earlier and have better results with the treatment (higher z-score variation).