ESPE Abstracts (2019) 92 P2-172

Differences of Efficiency of Treatment of Isolated Growth Hormone Deficiency and Panhypopituitarism in Children in Real Clinical Practice

Ekaterina Rudkova, Ivan Grisuk, Angelica Solntseva

Belarusian State Medical University, Minsk, Belarus

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.

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