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      Growth Hormone Deficiency: Strategies and Indications to Continue Growth Hormone Therapy in Transition from Adolescence to Adult Life

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          Abstract

          The most common practice in children with growth hormone (GH) deficiency is to discontinue GH treatment in adolescence after attainment of final height. Childhood-onset GH deficiency (GHD) that continues into adulthood and is not treated may be associated with more severe consequences than GHD acquired as an adult. This raises the question of the importance of GH for continuing tissue maturation after longitudinal growth has stopped. Data from recent studies suggest that muscle and bone maturation is arrested when GH treatment is discontinued at final height in adolescents in whom severe GHD continues into adulthood. These patients also develop, even in the short term, well-known cardiovascular risk factors associated with GHD in adults. Retesting for GHD is crucial in adolescence because a considerable number of patients will not have severe GHD according to the criteria set for adults. Continuing replacement therapy in these patients is warranted, but cost-benefit comparisons of treatment are still under debate and a lack of acceptance, and hence reimbursement, for such treatment is still common. In this review, the management and organization of transition, with and without continuing GH replacement therapy, are also discussed.

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          Most cited references 32

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          Consensus Guidelines for the Diagnosis and Treatment of Growth Hormone (GH) Deficiency in Childhood and Adolescence: Summary Statement of the GH Research Society

           G. Society (2000)
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            Association between premature mortality and hypopituitarism

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              Premature mortality due to cardiovascular disease in hypopituitarism

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                Author and article information

                Journal
                HRE
                Horm Res Paediatr
                10.1159/issn.1663-2818
                Hormone Research in Paediatrics
                S. Karger AG
                978-3-8055-7609-3
                978-3-318-00998-9
                1663-2818
                1663-2826
                2003
                July 2003
                17 November 2004
                : 60
                : Suppl 1
                : 78-85
                Affiliations
                aPituitary Research Unit, Garvan Institute of Medical Research, St Vincent’s Hospital, Sydney, NSW, Australia; bResearch Centre for Endocrinology and Metabolism, Sahlgrenska University Hospital, Göteborg, Sweden
                Article
                71231 Horm Res 2003;60(suppl 1):78–85
                10.1159/000071231
                12955023
                © 2003 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 2, References: 57, Pages: 8
                Categories
                Transition from Adolescence to Adult Life

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