ESPE Abstracts

Objectives: to describe the effect of GH therapy on thyroid function and the frequency of hypothyroidism during GH therapy.

Patients and methods: This is retrospective case series observational study of 120 children (62 male and 58 female) treated with rGH at Endocrine clinic in Benghazi children hospital (2002 – 2017), categorized according to indication of therapy to main four groups namely: Growth Hormone Deficiency (GHD), Idiopathic Short Stature (ISS), Small for Gestational Age (SGA), and Turner Syndrome. Study variables of all cases were evaluated as follows: age, sex, indication of GH, age at starting therapy, duration of treatment, height at initiation of GH therapy, height velocity in 1st year of therapy, height velocity in 2nd year of therapy, investigations extracted before starting of therapy: CBC, Blood sugar, RFT, LFT, TFT (T3, T4, TSH) and MRI.

Results: Total of 120 children were treated with rGH at Endocrine clinic (2002 – 2017). Children with organic brain lesions, systemic diseases, or syndromes that result in growth disorders (apart from TS) were excluded. Their median age at initiation of GH therapy was 11 years and duration ranged from 10mo to 12yrs with median of 3.5yrs. The most common indications for rGH therapy were Growth Hormone Deficiency (GHD) 48 (40 %), Idiopathic Short Stature (ISS) 36 (30.0 %), Small for Gestational Age (SGA) 22 (18.4 %) and Turner syndrome (TS) 14 (11.6%). Younger age at initiation of rGH therapy was associated with significant response to the treatment. This study shows that shifts in thyroid hormone levels are common during the first year of GH therapy in children who are initially euthyroid. Hypothyroidism however, is uncommon. most of children showed a decline in T4 values within normal range and no significant changes in TSH and T3 level. Only two euthyroid children ~ 1.9% developed central hypothyroidism during rhGH were diagnosed as GHD before treatment and their T4 level was near the lower end of the normal reference range.

Conclusion: All indications showed significant 1-year treatment response to therapy. There is gender deference in receiving rGH where GH indicated in male more than female. Younger age at initiation of rGH therapy was independently associated with significant response to therapy suggesting the importance of identifying children with short stature and prompt initiation of GH therapy. Shifts in thyroid hormone levels are common during the first year of GH therapy in children who are initially euthyroid and post GH is hypothyroidism