Title |
An audit of the management of childhood-onset growth hormone deficiency during young adulthood in Scotland
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Published in |
International Journal of Pediatric Endocrinology, March 2016
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DOI | 10.1186/s13633-016-0024-8 |
Pubmed ID | |
Authors |
M. Ahmid, V. Fisher, A. J. Graveling, S. McGeoch, E. McNeil, J. Roach, J. S. Bevan, L. Bath, M. Donaldson, G. Leese, A. Mason, C. G. Perry, N. N. Zammitt, S. F. Ahmed, M. G. Shaikh |
Abstract |
Adolescents with childhood onset growth hormone deficiency (CO-GHD) require re-evaluation of their growth hormone (GH) axis on attainment of final height to determine eligibility for adult GH therapy (rhGH). Retrospective multicentre review of management of young adults with CO-GHD in four paediatric centres in Scotland during transition. Medical records of 130 eligible CO-GHD adolescents (78 males), who attained final height between 2005 and 2013 were reviewed. Median (range) age at initial diagnosis of CO-GHD was 10.7 years (0.1-16.4) with a stimulated GH peak of 2.3 μg/l (0.1-6.5). Median age at initiation of rhGH was 10.8 years (0.4-17.0). Of the 130 CO-GHD adolescents, 74/130(57 %) had GH axis re-evaluation by stimulation tests /IGF-1 measurements. Of those, 61/74 (82 %) remained GHD with 51/74 (69 %) restarting adult rhGH. Predictors of persistent GHD included an organic hypothalamic-pituitary disorder and multiple pituitary hormone deficiencies (MPHD). Of the remaining 56/130 (43 %) patients who were not re-tested, 34/56 (61 %) were transferred to adult services on rhGH without biochemical retesting and 32/34 of these had MPHD. The proportion of adults who were offered rhGH without biochemical re-testing in the four centres ranged between 10 and 50 % of their total cohort. A substantial proportion of adults with CO-GHD remain GHD, particularly those with MPHD and most opt for treatment with rhGH. Despite clinical guidelines, there is significant variation in the management of CO-GHD in young adulthood across Scotland. |
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Unknown | 1 | 100% |
Demographic breakdown
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Members of the public | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 14 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Ph. D. Student | 3 | 21% |
Other | 2 | 14% |
Student > Master | 2 | 14% |
Lecturer | 1 | 7% |
Unspecified | 1 | 7% |
Other | 3 | 21% |
Unknown | 2 | 14% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 7 | 50% |
Unspecified | 1 | 7% |
Business, Management and Accounting | 1 | 7% |
Environmental Science | 1 | 7% |
Agricultural and Biological Sciences | 1 | 7% |
Other | 1 | 7% |
Unknown | 2 | 14% |