Review of Childhood-Onset Growth Hormone Deficiency: Diagnosis, Management, Monitoring, and Predictors for Persistence into Adulthood | ||
| The Egyptian Journal of Hospital Medicine | ||
| Volume 101, Issue 1, October 2025, Pages 5392-5396 PDF (698.56 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2025.407362.1804 | ||
| Authors | ||
| Basma Seif abdelkarim* 1; Amany Kamal El-Hawary2 | ||
| 1pediatrics, faculty of medicine, Horus university | ||
| 2Pediatric department, Faculty of Medicine, Mansoura University | ||
| Abstract | ||
| Background: Idiopathic growth hormone deficiency (IGHD) in childhood is a significant clinical condition, primarily characterized by growth failure and short stature (SS). It may also be associated with metabolic disturbances and cognitive dysfunction. Growth hormone replacement therapy (GHRT) plays a crucial role in management. Diagnosis typically involves a combination of clinical assessment, laboratory testing, and often brain imaging. Patient response to growth hormone stimulation test (GHST) varies, with lacking consensus on specific cut-off value. Objective: This study aimed to review the best practices and current guidelines for the diagnosis of IGHD, with a focus on GHST cut-off values at different time periods including during transition period, and the role of IGF-1, IGFBP, and brain imaging in diagnosis and follow-up. Methods: An electronic search was conducted using the Cochrane Library, Embase, Medline, and NHS websites esp., in the last 5 years for RCT, cohort, and case control studies and meticulous reviews to identify Pediatric Endocrine Society guidelines, consensus statements, and relevant English-language publications. Extracted data included patient demographics, epidemiology, clinical features, laboratory cut-off values, types of growth hormone replacement therapy (GHRT), indications for brain imaging, and predictors of persistent growth hormone deficiency into adulthood. Results: long-term GHRT is required if persistent GHD evident by GHST with cut-off value appropriate for adolescent transition plus or minus ILGF-1 and MRI pituitary criteria. Adherence issues prompt trials of sustained-release preparations. Conclusion: This review offers insights into GHD diagnosis, GHST cut-offs, clinical and laboratory monitoring, brain imaging, transition assessment with its predictors. | ||
| Keywords | ||
| Short stature; transition; growth hormone deficiency | ||
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