Baseline characteristics of patients on growth hormone therapy: Experience of two centers from South India
Babulreddy Hanmayyagari1, Mounika Guntaka2, Sunitha Chadalavada3, Voleti Sri Nagesh4, Sudhakar Reddy Pendyala5, Sridevi Patnala6
1 Department of Endocrinology, ESI Hospital, Hyderabad, Andhra Pradesh, India
2 Department of Biochemistry, Prime Hospital, KPHB, Hyderabad, Andhra Pradesh, India
3 Department of Endocrinology, ESI Hospital, Visakhapatnam, Andhra Pradesh, India
4 Department of Endocrinology, Care Hospital, Banjara Hills, Hyderabad, Andhra Pradesh, India
5 Department of Endocrinology, Yashoda Hospital, Hyderabad, Andhra Pradesh, India
6 Department of Endocrinology, Apollo Hospital, Secunderabad, Hyderabad, Andhra Pradesh, India
Dr. Babulreddy Hanmayyagari
Flat No - 507, Emerald Block, My Home Jewel, Madinaguda, Hyderabad - 500 049, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
Objective: The objective of this study is to determine the age at presentation, etiology and other characteristics of short children who are on growth hormone therapy (GHT) at a tertiary care hospital.
Materials and Methods: This cross-sectional study analyzed 96 children on GHT. All the children were assessed clinically, hormonally, radiologically, and genetic analysis were done wherever needed. GH deficiency (GHD) was diagnosed in the presence of short stature (height standard deviation score <2) and peak GH levels <10 ng/ml. Bone age (BA) was estimated by using Greulich-Pyle Atlas.
Results: Of 96 patients on GHT for short stature, 49 (51%) were male and 47 (49%) were female. Primary GHD (42.7%) was the most common diagnosis, followed by idiopathic short stature (ISS) and the rest were small-for-gestational age, multiple pituitary hormone deficiency, organic pituitary lesions and genetic syndromes. Mean chronological age at presentation was 9.5 ± 2.3 years (median: 10 years, range: 3-16 years), mean height age was 6.4 ± 1.8 years (median: 6.5 years, range: 1-14 years), mean BA was 6.8 ± 2.1 years (median: 7.4 years, range: 1.3-15 years) and mean height at presentation was 110 ± 18.2 cm (median: 120 cm, range: 74-142 cm). Two girls entered puberty during the study period and were managed with simultaneous GH and gonadotropin-releasing hormone analog treatment.
Conclusion: We conclude idiopathic GHD is the most common etiology in our patients on GHT followed by idiopathic short stature (ISS). In order to improve outcomes, short children need to be evaluated at the earliest.