Growth Hormone Replacement Therapy: Transition from Adolescence to Adulthood
Journal Title: Journal of Clinical Research in Pediatric Endocrinology - Year 2009, Vol 1, Issue 5
Abstract
Consideration of GH re-testing should be performed in all adolescents reaching the transition period (if not at start of puberty) who had been previously diagnosed with idiopathic, isolated GH deficiency. In the presence of multiple hormone deficiencies and/or clear-cut evidence of organic disease, persistence of severe GH deficiency is much more likely. Thus, GH deficiency may be “confirmed” by a low serum IGF-I concentration. During the transition period, the optimal time to reassess the integrity of the GH-IGF-I axis after prior GH treatment, the specific testing protocol to use, and the definition of GH deficiency all remain unknown. During the transition period, patients should have their GH dose lowered with (upward) adjustments made on the basis of age-and gender-adjusted serum IGF-I concentrations. GH treatment during the transition period has been shown in most, but not all, studies to be beneficial in preventing development of the features of the adult GH deficiency syndrome. It is important to remember that, during the transition period in teenagers with GH deficiency, there must be initiation of a careful plan for transfer of care to an intermist-endocrinologist with expertise in management of hypothalamic-pituitary disease in young adults. DOI: 10.4274/jcrpe.v1i5. 205
Authors and Affiliations
Mitchell E. Geffner
Genetics of Growth Hormone Deficiency
From the initiation of the primordium to the expression of mature growth hormone (GH)1 gene, a variety of genes, transcription factors, signalling pathways, and epigenetic control factors take part in the embryological d...
The relationship between serum ghrelin levels and hair zinc concentrations in children
Background: Zinc (Zn) plays a central role in the activation of numerous enzyme systems that synthesize and degrade bioactive peptides. Some of these bioactive peptides, also called neuropeptides, are involved in the reg...
Genetics of Obesity
The genetic basis of predispositon to obesity has been recognised for a long time. Several single gene-defects in rodents and humans cause the development of obesity. However these are extremely rare and an increase in g...
Growth Hormone Replacement Therapy: Transition from Adolescence to Adulthood
Consideration of GH re-testing should be performed in all adolescents reaching the transition period (if not at start of puberty) who had been previously diagnosed with idiopathic, isolated GH deficiency. In the presence...
A Patient with 22q11.2 Deletion Syndrome: case report
22q11 deletion is one of the most frequently encountered genetic syndromes. The phenotypic spectrum shows a wide variability. We report a boy who presented at age 11.9 years with seizures due to hypocalcemia as a result...