Introduction: Deficiency of growth hormone (GH) in children is manifested by pronounced stunting (below -2 sigmal abnormalities (SD)). Frequency of occurrence varies from 1:4000 to 1:10000 newborns.
Objective: To assess the effectiveness of treatment by comparing the dynamics of growth of children with isolated growth hormone deficiency (IGHD) and of children with panhypopituitarism (PHP).
Materials: Medical History of 53 patients aged from 3 to 18 years diagnosed with IGHD and PHP in 1998-2018 have been analyzed in the Republican Center for Pediatric Endocrinology.
Findings: Among 53 patients participating in the study (66% girls, 34% boys) 72% is with IGHD and 28% with PHP. It was revealed that before treatment, 39 patients had a significantly short stature (from 6 to 2.01 SDS); SDS of 14 patients (2 of them with PHP) was from -1.9 to -1. At the time of diagnosis, the mean height SDS was -2.3 in children with IGHD, while after completion of treatment, SDS was -1,4; height SDS was -2.3 before and -0.7 after treatment in children with PHP. The largest values of STH maximum level according to stimulation tests was 6.8 ± 5.2 ng/ml in group with IGHD and 3.6 ± 3.3 ng/ml in group with PHP (P <0.05). At the time of diagnosis, IGF-1 was below normal range in 72% of patients, after completion of treatment it was below normal range in 43%; at the same time, the IGF-1 level in the group with PHP was lower compared to the IGHD group (P <0.05) and were observed in 71.4 % of children. After GH treatment completion, IGF-1 remained below reference values in 57.1% of patients with PHP. A lagging of the bone age from the passport in the IGHD group before treatment was 2 years 5 months ± 1 year 3 months, after treatment it was 3 years 1 months ± 2 years 1 month; while in the group with PHP it was 3 years 2 months ± 2 year 8 months before and 3 year 1 month ± 2 year 7 months after treatment (P <0.05). The average dynamics of growth during the entire period of treatment in patients with IGHD is 6.9 ± 1.62 cm/year, while in patients with PHP it is 6.2± 2.73 cm/year (P <0.05).
Conclusion: Comparative analysis of the effectiveness of growth hormone treatment showed a significant dynamics of growth, more obvious in patients with IGHD.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology