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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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          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


                Author and article information

                Horm Res Paediatr
                Hormone Research in Paediatrics
                S. Karger AG
                July 2003
                17 November 2004
                : 60
                : Suppl 1
                : 78-85
                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
                71231 Horm Res 2003;60(suppl 1):78–85
                © 2003 S. Karger AG, Basel

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


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