Endocrine Abstracts (2002) 3 P167

An audit of paediatric to adult transition of childhood onset growth hormone deficiency

SA Nandlal, C Nelson & GS Conway

Department of Endocrinology, University College London, London, UK.

Cessation of hGH in GH deficient children generally occurs when final adult height has been obtained.Commonly, transition to adult clinics occurs in late teenage years,a time when patients are studying for A-levels, entering higher education or full time employment. It had been noticed that some patients were not doing as well in these areas as had been expected but that when adult hGH was commenced their performance improved.The aim of this audit was to try and investigate whether this was a widespread phenomenon.

This study comprised of a case note review of all individuals under the age of 30 who had transferred to adult endocrine clinics in the past five years. Of these, 22 were currently on hGH replacement. 15 of these 22 case notes were sufficently detailed for inclusion. The causes of GH deficiency in this group were isolated GH deficiency and panhypoptuitarism secondary to craniopharyngioma,histiocytosis X, surgery, irradiation and hypoplastic pituitary. The average age of stopping hGH was 17.8 years. The mean age between stopping paediatric hGH and starting adult therapy was 20.2 years. 5 of these patients experienced unexpected problems at university or work which resolved on starting hGH.

From this initial finding it may be concluded that in some GH deficient individuals there may be a role in adult replacement to maintain intellectual achievement. Of concern, failure in secondary or tertiary education may not be captured in quality of life assessments which are usually health based.

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