[Once growth hormone, always growth hormone? Transition from growth hormone therapy in childhood to adulthood].
The continuation of growth hormone treatment can be indicated in young adults who have been treated with growth hormone during childhood. However, in a large part of this population the diagnosis cannot be confirmed in adulthood. Therefore a retest procedure has to be performed once the final height has been attained. This procedure is only unnecessary in patients with deficiencies of two or more other pituitary hormone axes. The retest procedure can be performed one to three months after the growth hormone treatment has been discontinued, by means of an insulin tolerance test or, in the case of contraindications, by means of a combined growth hormone-releasing hormone(GHRH)-arginine test. If the growth hormone deficiency diagnosis is re-established, growth hormone treatment can be restarted. Patients are only eligible for a reimbursement of the growth hormone treatment costs from their health insurer, if the treatment indication is validated by the Dutch National Registry of Growth Hormone Treatment in Adults and the treatment results are included in a database. With this database insights into the long-term efficacy and safety of growth hormone treatment can be gained.
Drent
M L
ML
Afd. Endocrinologie, VU Medisch Centrum, De Boelelaan 1117, 1081 HV Amsterdam. ml.drent@vumc.nl
Delemarre-van de Waal
H A
HA
Wit
J M
JM
D000328:Adult; D000367:Age Factors; D002648:Child; D003937:Diagnosis, Differential; D013006:Growth Hormone / Q000191:economics / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy / Q000191:economics / Q000379:methods*; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis* / Q000191:economics; D019458:Insurance Coverage / Q000331:legislation & jurisprudence* / Q000592:standards; D009426:Netherlands; D012017:Referral and Consultation; D012042:Registries
D019382:Human Growth Hormone; D013006:Growth Hormone