Background: GH therapy in adolescents with childhood onset GH deficiency (CO-GHD) is often necessary to prevent adult GHD syndrome. This requires re-evaluation of the GH axis on attainment of final height.
Aim: Retrospective review of outcome in young adults diagnosed with CO-GHD Design: Clinical details were collected on young adults with CO-GHD patients between 2005 and 2011 at one tertiary centre. Result: 62 former CO-GHD patients, 40 male: 22 female, with median age 19.2 yr (15.026.2) were reviewed. The categories of GHD patients were craniopharyngioma (n=6), and other tumours (n=17), MPHD (n=6), IGHD (n=15), and other causes (n=18). Median age at diagnosis was 12.6 yr (0.719.4) with initial GH peak 7.6 mU/L (0.619.7). Of 62 patients, only 49 were treated with GH at median age 11.5 yr (1.217.2), and 35 of them were referred to the transition clinic at median age 17.9 yr (15.920.7) for adult GH therapy after withdrawal of GH at median age 16.35 yr (10.620) with median duration of treatment 4.5 yr (0.316.1). Of remaining GH treated group (n=14) patients were not referred for revaluation either because they were still on treatment not yet re-evaluated (n=6) or referred to the adult services without retesting (n=3) and lost to follow up while on treatment (n=5). Re-evaluation of GH axis was performed in 29/35 cases after 0.4 yr (0.174.3) of GH withdrawal with median repeat GH peak 3.7 mU/L (0.623.7), 27/29 remained GHD, with 25 re-starting adult therapy, 2 were not keen to re-start, 2 normal GH peak with missing data in 6 patients.
Conclusions: Optimal care of adults with CO-GHD requires a close relationship between paediatric and adult services. A substantial proportion of affected adults continue to have GHD and most opt for GH therapy. There is a need for a study of the current practice of assessment and management of CO-GHD in the UK.
Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.