Endocrine Abstracts

JOINT2599

Introduction: Diagnosing childhood-onset growth hormone deficiency (GHD) requires biochemical testing through provocative measures. Retesting in late adolescence or early adulthood is crucial to determine the need for continued recombinant human growth hormone (rhGH) treatment. Early retesting can prevent potential over-treatment of this condition.

Aim: We aimed to define the predictive criteria for children with GHD who may benefit from the reevaluation of GH status early in the course of rhGH treatment.

Methode: Seventy-five children with growth hormone deficiency were retested at least after one year of GH treatment. The initial clinical, laboratory characteristics and treatment response of those with a normal (GH ≥6. 7 ng/ml) and those with a subnormal response were compared.

Results: After retesting, 31 (41. 3%) patients had a GH response of ≥6. 7 ng/ml. The mean age at revaluation was 12. 1±3. 8 years and the mean duration of GH treatment was 4. 13±2. 4 years. Children with permanent GHD are significantly smaller at diagnosis (-3. 28 vs -2. 65 SDS), have a higher height gain (1. 99 vs 1. 33 SDS) and more MRI abnormalities (P < 0. 0001). Biochemical parameters: IGF1 SDS at diagnosis, IGF1 at re-evaluation SDS, initial GH peak, re-evaluation GH peak, were all significantly lower in the permanent GHD group (P < 0. 0001).

Dicussion: The present findings are in agreement with those previously reported by other groups, which demonstrated that the GH response to stimulation was found to be normalised in a number of patients diagnosed with GHD. The results of the present study carry significant clinical implications, in terms of both the accuracy of diagnosis and the efficacy of therapeutic decisions, with the objective of avoiding the cost and burden of long-term growth hormone (GH) treatment, the efficacy of which is uncertain.

Conclusion: Early retesting is recommended for paediatric patients with suspected growth hormone (GH) deficiency to ensure accurate diagnosis.