HIGHLY INCREASED RISK OF GROWTH HORMONE DEFICIENCY (GHD) IN CHILDREN WITH A HISTORY OF SURGERY OF THE SELLAR OR SUPRASELLAR REGION OR ANOTHER ANTERIOR PITUITARY DEFICIENCY

CLEMENT MF; KESELMAN A; BALLERINI MG; REY R; MARTIN BENITEZ S; BRASLAVSKY D; ROPELATO MG; FINKIELSTAIN G; GRINSPON R; MARTINEZ A,; BERGADÁ I

Washington

Congreso; 10th International Meeting of Pediatric Endocrinology; 2017

The global community of pediatric endocrinology

Objectives: Growth hormone stimulation testing (GHST) has been a standard practice required for the diagnosis of growth hormone deficiency (GHD). However, GHST may raise safety issues in a patient with co-morbidities.The objective was to test whether there is an increased risk of GHD in patients having a history of surgery of the sellar and/or suprasellar region, one or more anterior pituitary hormone deficiencies associated with diabetes insipidus, congenital hypogenitalism in males, neonatal hypoglicaemia, neonatal cholestasis, craniofacial midline defects or pituitary dysgenesis by imaging studies.Methods: Case-control study to assess the association between highly suggestive risk factors and the existence of GHD.Retrospective clinical chart review of all patients meeting the criteria for GHST, according to the Summary Statement of the GH Research Society, during a period 10 years (6/2004-5/2014). GHD diagnosis was based on maximal stimulated- GH < 6.0 ug/L (WHO 80/505) or < 4.7 ng/ml (WHO 98/574) after pharmacological stimuli of arginine (0.5 g/kg body weight) and/or clonidine (100 ug/m2 body surface) tests.Results: A total of 671 patients were analyzed. Out of 142 patients with GHD, 93 had the postulated risk factors, while these were found in 7 of the 529 patients without GHD. There was a strong association between GHD and the existence of at least one of the postulated risk factors (Fisher´s exact test P