TY - JOUR
T1 - Advances in differential diagnosis and management of growth hormone deficiency in children
AU - Hage, Camille
AU - Gan, Hoong Wei
AU - Ibba, Anastasia
AU - Patti, Giuseppa
AU - Dattani, Mehul
AU - Loche, Sandro
AU - Maghnie, Mohamad
AU - Salvatori, Roberto
N1 - Publisher Copyright:
© 2021, Springer Nature Limited.
PY - 2021/10
Y1 - 2021/10
N2 - Growth hormone (GH) deficiency (GHD) in children is defined as impaired production of GH by the pituitary gland that results in growth failure. This disease might be congenital or acquired, and occurs in isolation or in the setting of multiple pituitary hormone deficiency. Isolated GHD has an estimated prevalence of 1 patient per 4000–10,000 live births and can be due to multiple causes, some of which are yet to be determined. Establishing the correct diagnosis remains key in children with short stature, as initiating treatment with recombinant human GH can help them attain their genetically determined adult height. During the past two decades, our understanding of the benefits of continuing GH therapy throughout the transition period from childhood to adulthood has increased. Improvements in transitional care will help alleviate the consequent physical and psychological problems that can arise from adult GHD, although the consequences of a lack of hormone replacement are less severe in adults than in children. In this Review, we discuss the differential diagnosis in children with GHD, including details of clinical presentation, neuroimaging and genetic testing. Furthermore, we highlight advances and issues in the management of GHD, including details of transitional care.
AB - Growth hormone (GH) deficiency (GHD) in children is defined as impaired production of GH by the pituitary gland that results in growth failure. This disease might be congenital or acquired, and occurs in isolation or in the setting of multiple pituitary hormone deficiency. Isolated GHD has an estimated prevalence of 1 patient per 4000–10,000 live births and can be due to multiple causes, some of which are yet to be determined. Establishing the correct diagnosis remains key in children with short stature, as initiating treatment with recombinant human GH can help them attain their genetically determined adult height. During the past two decades, our understanding of the benefits of continuing GH therapy throughout the transition period from childhood to adulthood has increased. Improvements in transitional care will help alleviate the consequent physical and psychological problems that can arise from adult GHD, although the consequences of a lack of hormone replacement are less severe in adults than in children. In this Review, we discuss the differential diagnosis in children with GHD, including details of clinical presentation, neuroimaging and genetic testing. Furthermore, we highlight advances and issues in the management of GHD, including details of transitional care.
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U2 - 10.1038/s41574-021-00539-5
DO - 10.1038/s41574-021-00539-5
M3 - Review article
C2 - 34417587
AN - SCOPUS:85113258224
SN - 1759-5029
VL - 17
SP - 608
EP - 624
JO - Nature Reviews Endocrinology
JF - Nature Reviews Endocrinology
IS - 10
ER -