title: Natural history of growth hormone deficiency in a pediatric cohort.
abstract: OBJECTIVE
  Controversies still exist regarding the evaluation of growth hormone deficiency (GHD) in childhood at the end of growth. The aim of this study was to describe the natural history of GHD in a pediatric cohort.
  
  
  METHODS
  This is a retrospective study of a cohort of pediatric patients with GHD. Cases of acquired GHD were excluded. Univariate logistic regression was used to identify predictors of GHD persisting into adulthood.
  
  
  RESULTS
  Among 63 identified patients, 47 (75%) had partial GHD at diagnosis, while 16 (25%) had complete GHD, including 5 with multiple pituitary hormone deficiencies. At final height, 50 patients underwent repeat stimulation testing; 28 (56%) recovered and 22 (44%) remained growth hormone (GH) deficient. Predictors of persisting GHD were: complete GHD at diagnosis (OR 10.1, 95% CI 2.4-42.1), pituitary stalk defect or ectopic pituitary gland on magnetic resonance imaging (OR 6.5, 95% CI 1.1-37.1), greater height gain during GH treatment (OR 1.8, 95% CI 1.0-3.3), and IGF-1 level <-2 standard deviation scores (SDS) following treatment cessation (OR 19.3, 95% CI 3.6-103.1). In the multivariate analysis, only IGF-1 level <-2 SDS (OR 13.3, 95% CI 2.3-77.3) and complete GHD (OR 6.3, 95% CI 1.2-32.8) were associated with the outcome.
  
  
  CONCLUSIONS
  At final height, 56% of adolescents with GHD had recovered. Complete GHD at diagnosis, low IGF-1 levels following retesting, and pituitary malformation were strong predictors of persistence of GHD.
authors: Division of Endocrinology, Diabetology and Obesity, University Hospital Lausanne, Lausanne, Switzerland.
authors: Eva
authors: E
authors: Deillon
authors: Michael
authors: M
authors: Hauschild
authors: Mohamed
authors: M
authors: Faouzi
authors: Sophie
authors: S
authors: Stoppa-Vaucher
authors: Eglantine
authors: E
authors: Elowe-Gruau
authors: Andrew
authors: A
authors: Dwyer
authors: Gerald E
authors: GE
authors: Theintz
authors: Jean-Michel
authors: JM
authors: Dubuis
authors: Primus E
authors: PE
authors: Mullis
authors: Nelly
authors: N
authors: Pitteloud
authors: Franziska
authors: F
authors: Phan-Hug
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D012189:Retrospective Studies
chemical_list: D019382:Human Growth Hormone