Endocrine Abstracts

Introduction: Growth hormone deficiency (GHD) is a rare cause of growth retardation whose diagnosis remains relatively late. Its etiologies are multiple, and its treatment could improve the stature prognosis of the children. The objective of this study was to describe the clinical, biological, radiological, and therapeutic characteristics of GHD, and its outcomes after treatment.

Methods: A cross-sectional study was conducted in the Endocrinology department of Farhat Hached University Hospital in Sousse, between January 2000 and December 2015, collecting 102 patients following for GHD.

Results: The average age at diagnosis was 12±3.83 years with a sex ratio of 1.61. The average height was -3±0.9 SD. The mean bone age was 9.4±3.7 years with an average of 2.7±2 years delay comparing to the chronological age. GHD was associated with other pituitary deficiency in 38.2% of patients and it was complete in 63.7% of cases. A partial GHD (36.3%) was associated significantly with isolated GHD (P=0.02) and idiopathic GHD (P=10^-3). Pituitary MRI was normal in 63.5% of cases, otherwise, it showed an interruption of the pituitary stalk (17.5%), a tumor (12.7%), an empty Sella (3.17%) and hypoplasia of the anterior pituitary (3.17%). Most patients (73.5%) were treated with somatropin with an average dose of 0.7 U/kg/week and an average duration of 3 years. The average height gain under treatment was 1±0.9 SD. Height recovery was significant during the first year of treatment. No side effects of rhGH were observed. A statistically significant negative correlation between height gain and chronological age, height in SD and bone age at the start of treatment were found. Also, there was a statistically significant positive correlation between the height gain and the therapeutic compliance as well as an injection rhythm at 5/7 days, and especially the duration of the treatment.

Conclusions: Our study revealed a diagnostic delay in children with GHD. We insist on early diagnosis and treatment to improve the stature prognosis of these children. We must improve therapeutic compliance, necessary for a better response to treatment, through regular monitoring and good education of the child and those around him.