title: Current practice in diagnosis and treatment of growth hormone deficiency in childhood: a survey from Turkey.
abstract: OBJECTIVE
  Approaches to diagnosis and treatment of growth hormone deficiency (GHD) in children vary among countries and even among centers in the same country. This survey, aiming to facilitate the process of preparing the new consensus on GHD by the Turkish Pediatric Endocrinology and Diabetes Society, was designed to evaluate the current practices in diagnosis and treatment of GHD in different centers in Turkey.
  
  
  METHODS
  A questionnaire covering relevant items for diagnosis and treatment of GHD was sent out to all pediatric endocrinology centers.
  
  
  RESULTS
  Twenty-four centers returned the questionnaire. The most frequently used GH stimulation test was L-dopa, followed by clonidine. Eighteen centers used a GH cut-off value of 10 ng/mL for the diagnosis of GHD; this value was 7 ng/mL in 4 centers and 5 ng/mL in 2 centers. The most frequently used assay was immunochemiluminescence for determination of GH, insulin-like growth factor-1 and insulin-like growth factor binding protein-3 concentrations. Sex steroid priming in both sexes was used by 19 centers. The most frequently used starting dose of recombinant human GH (rhGH) in prepubertal children was 0.025-0.030 mg/kg/day and 0.030-0.035 mg/kg/day in pubertal children. Growth velocity was used in the evaluation for growth response to rhGH therapy in all centers. Anthropometric measurements of patients every 3-6 months, fasting blood glucose, bone age and thyroid panel evaluation were used by all centers at follow-up. Main indications for cessation of therapy were decreased height velocity and advanced bone age. Fourteen centers used combined treatment (rhGH and gonadotropin-releasing analogues) to increase final height.
  
  
  CONCLUSIONS
  Although conformity was found among centers in Turkey in current practice, it is very important to update guideline statements and to modify, if needed, the approach to GHD over time in accordance with new evidence-based clinical studies.
authors: İstanbul University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey. Phone: +90 414 20 00/31645 E-mail: sukranpoyrazoglu@yahoo.com.
authors: Şükran
authors: Ş
authors: Poyrazoğlu
authors: Teoman
authors: T
authors: Akçay
authors: İlknur
authors: İ
authors: Arslanoğlu
authors: Mehmet Emre
authors: ME
authors: Atabek
authors: Zeynep
authors: Z
authors: Atay
authors: Merih
authors: M
authors: Berberoğlu
authors: Abdullah
authors: A
authors: Bereket
authors: Aysun
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authors: Bideci
authors: İffet
authors: İ
authors: Bircan
authors: Ece
authors: E
authors: Böber
authors: Şule
authors: Ş
authors: Can
authors: Yaşar
authors: Y
authors: Cesur
authors: Şükran
authors: Ş
authors: Darcan
authors: Korcan
authors: K
authors: Demir
authors: Bumin
authors: B
authors: Dündar
authors: Betül
authors: B
authors: Ersoy
authors: İhsan
authors: İ
authors: Esen
authors: Ayla
authors: A
authors: Güven
authors: Cengiz
authors: C
authors: Kara
authors: Mehmet
authors: M
authors: Keskin
authors: Selim
authors: S
authors: Kurtoğlu
authors: Nihal
authors: N
authors: Memioğlu
authors: Mehmet Nuri
authors: MN
authors: Özbek
authors: Tolga
authors: T
authors: Özgen
authors: Erkan
authors: E
authors: Sarı
authors: Zeynep
authors: Z
authors: Şıklar
authors: Enver
authors: E
authors: Şimşek
authors: Serap
authors: S
authors: Turan
authors: Ediz
authors: E
authors: Yeşilkaya
authors: Bilgin
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authors: Yüksel
authors: Feyza
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authors: Darendeliler
mesh_terms: D000293:Adolescent; D001827:Body Height / Q000187:drug effects; D002648:Child; D019963:Clinical Chemistry Tests; D004393:Dwarfism, Pituitary / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D019382:Human Growth Hormone / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000032:analysis; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D011994:Recombinant Proteins / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D014421:Turkey / Q000453:epidemiology
chemical_list: D018972:Insulin-Like Growth Factor Binding Protein 3; D011994:Recombinant Proteins; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I