Management of Adults with Childhood-Onset Growth Hormone Deficiency

  • Alessandro Prete
  • Roberto Salvatori


In patients with childhood-onset growth hormone (GH) deficiency, linear growth is the most evident and objective parameter to monitor GH therapy during infancy and puberty. Once adult height is achieved and the patient transits from puberty to adulthood, confirmation of the diagnosis of GH deficiency (GHD) may be needed in order to assess the need for long-term replacement therapy. Depending on the etiology of GHD, patients have different chances of having persistent deficit. Most of the children with an isolated, idiopathic GHD are likely to restore a physiological secretion during transition, whereas those with anatomic hypothalamic-pituitary damage and/or multiple pituitary hormone deficiencies have a higher likelihood of remaining GH deficient. Retesting the patient during transition from puberty to adulthood can be challenging; there are no basal laboratory tests able to confirm GHD in most of cases, and dynamic evaluation is influenced by several variables that might make it difficult to interpret the results. The decision on if, when, and how to treat with long-term GH replacement therapy (GHRT) has to be tailored on every single case. This treatment has proven benefits on bone maturation, metabolism control, and quality of life. However, it has contraindications and potential side effects as well, and the decision to restart the treatment should be discussed extensively with the patients and their families.


GH Insulin-like growth factor 1 (IGF-1) GH deficiency GH replacement therapy Transition Bone mineral density Bone peak Body composition Metabolic syndrome Quality of life Insulin tolerance test Arginine + GHRH test Glucagon stimulation est Hypopituitarism Adrenal insufficiency Hypothyroidism 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institute of Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
  2. 2.Division of Endocrinology, Department of MedicineJohns Hopkins UniversityBaltimoreUSA

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