Endocrine Abstracts

Introduction

Growth hormone (GH ) deficiency is a rare but not exceptional cause of statural delay in children. The results of GH stimulation tests and the exploration of other pituitary axes allow us to conclude on the nature of the deficiency: total or partial and its possible association with other pituitary deficits.

Methods

This is a retrospective descriptive study including 75 patients followed for congenital GH deficiency.

Results

The comparison of the demographic, auxological and biological characteristics between total and partial somatotropic deficits showed that the average age of discovery was 8.51 ± 4.21 years for the total deficit vs 9.62 ± 4.09 years for the partial deficit with no significant difference (P = 0.344). Male gender was predominant for both types of deficits (61% for total deficit vs 67% for partial deficit; P = 0.639). The initial SD height was –2.77 ± 1.5 SD for total deficit vs –2.19 ± 1.2 SD for partial deficit. BMI (SD) was 1.27 ± 0.5 for total deficit vs 1.75 ± 0.5 for partial deficit (P = 0.251). IGF1 (SD) was 3.36 ± 0.33 vs 2.81 ± 0.5 (P = 0.474). The hypothalamic-pituitary MRI was pathological for most patients with total somatotropic deficit (60%) and normal for most patients with partial deficit (67%) with a significant difference (P = 0.038). For the comparison between isolated and combined deficits, we found a significant difference only for IGF1(SD) (which was –3 ± 1.5 SD for isolated deficit and -3.44 ± 0.5 SD for combined deficit (P = 0.002).

Discussion and conclusion

The total deficit was mainly associated with pathological MRI in our series, which was consistent with the series in the literature. For the other series, patients with combined pituitary deficit compared to subjects with isolated deficit were significantly smaller in height, with a larger delta (target height-height) and lower weight.