Abstract
Objective: To determine characteristics of children initially diagnosed with isolated growth hormone deficiency (IGHD) of organic aetiology, who later developed multiple pituitary hormone deficiencies (MPHD). Design: Data were analysed for 716 growth hormone-treated children with organic IGHD, who were growth hormone-naive at baseline in the multinational, observational Genetics and Neuroendocrinology of Short Stature International Study. Methods: Development of MPHD was ascertained from investigator-provided diagnoses, adverse events and concomitant medications. Analyses were performed for all patients and separately for those who developed MPHD within 4.5 years or had >3.5 years follow-up and continued to have IGHD (4-year cohort). Results: MPHD developed in 71/716 (9.9%) children overall, and in 60/290 (20.7%) in the 4-year cohort. The most frequent additional deficiencies were thyroid-stimulating hormone (47 patients) and gonadotropins (23 patients). Compared with those who remained with IGHD, children who developed MPHD had more severe GHD at study entry, significantly lower baseline insulin-like growth factor1, peak stimulated growth hormone, and more frequent diagnosis of intracranial tumour or mutation of gene(s) controlling hypothalamic-pituitary development and/or function. Multivariate logistic regression analyses identified female gender, longer follow-up, higher baseline age and lower peak stimulated growth hormone as predictors of MPHD development. Conclusions: MPHD is more likely to develop in patients with severe organic IGHD, especially those with history of intracranial tumour or mutation of gene(s) controlling hypothalamic-pituitary development and/or function. Older baseline age, female gender and longer follow-up duration were also associated with higher incidence of MPHD. Long-term monitoring of pituitary function is recommended, irrespective of the aetiology of GHD.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 669-679 |
| Number of pages | 11 |
| Journal | European Journal of Endocrinology |
| Volume | 174 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 1 2016 |
Fingerprint
ASJC Scopus subject areas
- Endocrinology
- Endocrinology, Diabetes and Metabolism
Cite this
Development of additional pituitary hormone deficiencies in pediatric patients originally diagnosed with isolated growth hormone deficiency due to organic causes. / Child, Christopher J.; Blum, Werner F.; Deal, Cheri; Zimmermann, Alan G.; Quigley, Charmian A.; Drop, Stenvert L S; Cutler, Gordon B.; Rosenfeld, Ronald (Ron).
In: European Journal of Endocrinology, Vol. 174, No. 5, 01.05.2016, p. 669-679.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Development of additional pituitary hormone deficiencies in pediatric patients originally diagnosed with isolated growth hormone deficiency due to organic causes
AU - Child, Christopher J.
AU - Blum, Werner F.
AU - Deal, Cheri
AU - Zimmermann, Alan G.
AU - Quigley, Charmian A.
AU - Drop, Stenvert L S
AU - Cutler, Gordon B.
AU - Rosenfeld, Ronald (Ron)
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Objective: To determine characteristics of children initially diagnosed with isolated growth hormone deficiency (IGHD) of organic aetiology, who later developed multiple pituitary hormone deficiencies (MPHD). Design: Data were analysed for 716 growth hormone-treated children with organic IGHD, who were growth hormone-naive at baseline in the multinational, observational Genetics and Neuroendocrinology of Short Stature International Study. Methods: Development of MPHD was ascertained from investigator-provided diagnoses, adverse events and concomitant medications. Analyses were performed for all patients and separately for those who developed MPHD within 4.5 years or had >3.5 years follow-up and continued to have IGHD (4-year cohort). Results: MPHD developed in 71/716 (9.9%) children overall, and in 60/290 (20.7%) in the 4-year cohort. The most frequent additional deficiencies were thyroid-stimulating hormone (47 patients) and gonadotropins (23 patients). Compared with those who remained with IGHD, children who developed MPHD had more severe GHD at study entry, significantly lower baseline insulin-like growth factor1, peak stimulated growth hormone, and more frequent diagnosis of intracranial tumour or mutation of gene(s) controlling hypothalamic-pituitary development and/or function. Multivariate logistic regression analyses identified female gender, longer follow-up, higher baseline age and lower peak stimulated growth hormone as predictors of MPHD development. Conclusions: MPHD is more likely to develop in patients with severe organic IGHD, especially those with history of intracranial tumour or mutation of gene(s) controlling hypothalamic-pituitary development and/or function. Older baseline age, female gender and longer follow-up duration were also associated with higher incidence of MPHD. Long-term monitoring of pituitary function is recommended, irrespective of the aetiology of GHD.
AB - Objective: To determine characteristics of children initially diagnosed with isolated growth hormone deficiency (IGHD) of organic aetiology, who later developed multiple pituitary hormone deficiencies (MPHD). Design: Data were analysed for 716 growth hormone-treated children with organic IGHD, who were growth hormone-naive at baseline in the multinational, observational Genetics and Neuroendocrinology of Short Stature International Study. Methods: Development of MPHD was ascertained from investigator-provided diagnoses, adverse events and concomitant medications. Analyses were performed for all patients and separately for those who developed MPHD within 4.5 years or had >3.5 years follow-up and continued to have IGHD (4-year cohort). Results: MPHD developed in 71/716 (9.9%) children overall, and in 60/290 (20.7%) in the 4-year cohort. The most frequent additional deficiencies were thyroid-stimulating hormone (47 patients) and gonadotropins (23 patients). Compared with those who remained with IGHD, children who developed MPHD had more severe GHD at study entry, significantly lower baseline insulin-like growth factor1, peak stimulated growth hormone, and more frequent diagnosis of intracranial tumour or mutation of gene(s) controlling hypothalamic-pituitary development and/or function. Multivariate logistic regression analyses identified female gender, longer follow-up, higher baseline age and lower peak stimulated growth hormone as predictors of MPHD development. Conclusions: MPHD is more likely to develop in patients with severe organic IGHD, especially those with history of intracranial tumour or mutation of gene(s) controlling hypothalamic-pituitary development and/or function. Older baseline age, female gender and longer follow-up duration were also associated with higher incidence of MPHD. Long-term monitoring of pituitary function is recommended, irrespective of the aetiology of GHD.
UR - http://www.scopus.com/inward/record.url?scp=84969926583&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84969926583&partnerID=8YFLogxK
U2 - 10.1530/EJE-15-1203
DO - 10.1530/EJE-15-1203
M3 - Article
C2 - 26888628
AN - SCOPUS:84969926583
VL - 174
SP - 669
EP - 679
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
SN - 0804-4643
IS - 5
ER -