Document Type : Original Article
Authors
1
pediatrics, faculty of medicine, Horus university
2
Pediatric 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
Main Subjects
)
View on SCiNiTO