Growth hormone deficiency and the transition from pediatric to adult care

Detalhes bibliográficos
Autor(a) principal: Tavares,Ana Beatriz Winter
Data de Publicação: 2021
Outros Autores: Collett-Solberg,Paulo Ferrez
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal de Pediatria (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572021000600595
Resumo: Abstract Objective: To discuss the approach to patients diagnosed with growth hormone deficiency (GHD) in childhood during the transition period from puberty to adulthood, focusing on the following: (1) physiology; (2) effects of recombinant human GH (rhGH) interruption/reinstitution after adult height achievement; (3) re-evaluation of somatrotropic axis; (4) management of rhGH reinstitution, when necessary. Source of data: Narrative review of the literature published at PubMed/MEDLINE until September 2020 including original and review articles, systematic reviews and meta-analyses. Synthesis of data: Growth hormone is crucial for the attainment of normal growth and for adequate somatic development, which does not end concomitantly with linear growth. Retesting adolescents who already meet the criteria that predict adult GHD with high specificity is not necessary. Patients with isolated GHD have a high likelihood of normal response to GH testing after puberty. Adolescents with confirmed GHD upon retesting should restart rhGH replacement and be monitored according to IGF-I levels, clinical parameters, and complementary exams. Conclusion: Patients with isolated idiopathic GHD in childhood are a special group who must be reevaluated for GHD as many of them have normal GH provocative tests upon retesting after puberty. Patients who confirm the persistence of GHD in the transition period should maintain rhGH replacement in order to reach an ideal peak bone mass, satisfactory body composition, lipid and glucose profiles, and quality of life.
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spelling Growth hormone deficiency and the transition from pediatric to adult careGrowth hormoneHypopituitarismAdolescentMetabolismGrowth and developmentTherapeuticsAbstract Objective: To discuss the approach to patients diagnosed with growth hormone deficiency (GHD) in childhood during the transition period from puberty to adulthood, focusing on the following: (1) physiology; (2) effects of recombinant human GH (rhGH) interruption/reinstitution after adult height achievement; (3) re-evaluation of somatrotropic axis; (4) management of rhGH reinstitution, when necessary. Source of data: Narrative review of the literature published at PubMed/MEDLINE until September 2020 including original and review articles, systematic reviews and meta-analyses. Synthesis of data: Growth hormone is crucial for the attainment of normal growth and for adequate somatic development, which does not end concomitantly with linear growth. Retesting adolescents who already meet the criteria that predict adult GHD with high specificity is not necessary. Patients with isolated GHD have a high likelihood of normal response to GH testing after puberty. Adolescents with confirmed GHD upon retesting should restart rhGH replacement and be monitored according to IGF-I levels, clinical parameters, and complementary exams. Conclusion: Patients with isolated idiopathic GHD in childhood are a special group who must be reevaluated for GHD as many of them have normal GH provocative tests upon retesting after puberty. Patients who confirm the persistence of GHD in the transition period should maintain rhGH replacement in order to reach an ideal peak bone mass, satisfactory body composition, lipid and glucose profiles, and quality of life.Sociedade Brasileira de Pediatria2021-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572021000600595Jornal de Pediatria v.97 n.6 2021reponame:Jornal de Pediatria (Online)instname:Sociedade Brasileira de Pediatria (SBP)instacron:SBPE10.1016/j.jped.2021.02.007info:eu-repo/semantics/openAccessTavares,Ana Beatriz WinterCollett-Solberg,Paulo Ferrezeng2021-12-02T00:00:00Zoai:scielo:S0021-75572021000600595Revistahttp://www.jped.com.br/https://old.scielo.br/oai/scielo-oai.php||jped@jped.com.br1678-47820021-7557opendoar:2021-12-02T00:00Jornal de Pediatria (Online) - Sociedade Brasileira de Pediatria (SBP)false
dc.title.none.fl_str_mv Growth hormone deficiency and the transition from pediatric to adult care
title Growth hormone deficiency and the transition from pediatric to adult care
spellingShingle Growth hormone deficiency and the transition from pediatric to adult care
Tavares,Ana Beatriz Winter
Growth hormone
Hypopituitarism
Adolescent
Metabolism
Growth and development
Therapeutics
title_short Growth hormone deficiency and the transition from pediatric to adult care
title_full Growth hormone deficiency and the transition from pediatric to adult care
title_fullStr Growth hormone deficiency and the transition from pediatric to adult care
title_full_unstemmed Growth hormone deficiency and the transition from pediatric to adult care
title_sort Growth hormone deficiency and the transition from pediatric to adult care
author Tavares,Ana Beatriz Winter
author_facet Tavares,Ana Beatriz Winter
Collett-Solberg,Paulo Ferrez
author_role author
author2 Collett-Solberg,Paulo Ferrez
author2_role author
dc.contributor.author.fl_str_mv Tavares,Ana Beatriz Winter
Collett-Solberg,Paulo Ferrez
dc.subject.por.fl_str_mv Growth hormone
Hypopituitarism
Adolescent
Metabolism
Growth and development
Therapeutics
topic Growth hormone
Hypopituitarism
Adolescent
Metabolism
Growth and development
Therapeutics
description Abstract Objective: To discuss the approach to patients diagnosed with growth hormone deficiency (GHD) in childhood during the transition period from puberty to adulthood, focusing on the following: (1) physiology; (2) effects of recombinant human GH (rhGH) interruption/reinstitution after adult height achievement; (3) re-evaluation of somatrotropic axis; (4) management of rhGH reinstitution, when necessary. Source of data: Narrative review of the literature published at PubMed/MEDLINE until September 2020 including original and review articles, systematic reviews and meta-analyses. Synthesis of data: Growth hormone is crucial for the attainment of normal growth and for adequate somatic development, which does not end concomitantly with linear growth. Retesting adolescents who already meet the criteria that predict adult GHD with high specificity is not necessary. Patients with isolated GHD have a high likelihood of normal response to GH testing after puberty. Adolescents with confirmed GHD upon retesting should restart rhGH replacement and be monitored according to IGF-I levels, clinical parameters, and complementary exams. Conclusion: Patients with isolated idiopathic GHD in childhood are a special group who must be reevaluated for GHD as many of them have normal GH provocative tests upon retesting after puberty. Patients who confirm the persistence of GHD in the transition period should maintain rhGH replacement in order to reach an ideal peak bone mass, satisfactory body composition, lipid and glucose profiles, and quality of life.
publishDate 2021
dc.date.none.fl_str_mv 2021-12-01
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572021000600595
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1016/j.jped.2021.02.007
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Pediatria
publisher.none.fl_str_mv Sociedade Brasileira de Pediatria
dc.source.none.fl_str_mv Jornal de Pediatria v.97 n.6 2021
reponame:Jornal de Pediatria (Online)
instname:Sociedade Brasileira de Pediatria (SBP)
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