scholarly journals Impact of Pituitary Autoimmunity and Genetic Disorders on Growth Hormone Deficiency in Children and Adults

2020 ◽  
Vol 21 (4) ◽  
pp. 1392 ◽  
Author(s):  
Giuseppe Bellastella ◽  
Maria Ida Maiorino ◽  
Miriam Longo ◽  
Paolo Cirillo ◽  
Lorenzo Scappaticcio ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Bone Growth ◽  
Genetic Disorders ◽  
Genetic Alterations ◽  
Hormone Deficiency ◽  
Genetic Syndromes ◽  
Immune Alterations ◽  
And Function ◽  
The Impact ◽  
Fundamental Action

Growth hormone (GH), mostly through its peripheral mediator, the insulin-like growth factor 1(IGF1), in addition to carrying out its fundamental action to promote linear bone growth, plays an important role throughout life in the regulation of intermediate metabolism, trophism and function of various organs, especially the cardiovascular, muscular and skeletal systems. Therefore, if a prepubertal GH secretory deficiency (GHD) is responsible for short stature, then a deficiency in adulthood identifies a nosographic picture classified as adult GHD syndrome, which is characterized by heart, muscle, bone, metabolic and psychic abnormalities. A GHD may occur in patients with pituitary autoimmunity; moreover, GHD may also be one of the features of some genetic syndromes in association with other neurological, somatic and immune alterations. This review will discuss the impact of pituitary autoimmunity on GHD and the occurrence of GHD in the context of some genetic disorders. Moreover, we will discuss some genetic alterations that cause GH and IGF-1 insensitivity and the arguments in favor and against the influence of GH/IGF-1 on longevity and cancer in the light of the papers on these issues that so far appear in the literature.

The impact of idiopathic childhood-onset growth hormone deficiency (GHD) on bone mass in subjects without adult GHD

2005 ◽  
Vol 62 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Martin Lange ◽  
Jorn Muller ◽  
Ole Lander Svendsen ◽  
Knud William Kastrup ◽  
Anders Juul ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Bone Mass ◽  
Growth Hormone Deficiency ◽  
Hormone Deficiency ◽  
Childhood Onset ◽  
The Impact

scholarly journals Thyroid Profile abnormalities of RHGH treated children

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
W A Mouharam ◽  
D A Soliman
Keyword(s):  
Growth Hormone ◽  
Thyroid Function ◽  
Optimal Growth ◽  
Hormone Treatment ◽  
Hormone Deficiency ◽  
Height Velocity ◽  
Free T4 ◽  
Thyroid Profile ◽  
The Impact ◽  
Rhgh Treatment

Abstract Objective Normal thyroid function is important for optimal growth. Contradictory studies are available on the impact of rhGH treatment on thyroid function. Study aim is to evaluate the effect of rhGH treatment on thyroid function. Methods Study involved 102 euthyroid, prepubertal patients with growth hormone deficiency treated with rhGH. For all children, basal thyroid function, height, height velocity after 1 year of treatment, thyroid function every 3 months during the first year of treatment, all were performed. Results At 3 months of treatment 12 patients had elevated TSH, with or without low free T4. The remaining patients had normal free T4 (but lower than the basal one in most of the patients), with no TSH difference. The latter results were normalized at 1 year. Growth velocity was significantly lower in patients with hypothyroidism. Conclusion Thyroid profile may be affected in patients with short stature on growth hormone treatment which may negatively impact treatment response.

scholarly journals Thyroid Hormone Changes Related to Growth Hormone Therapy in Growth Hormone Deficient Patients

2021 ◽  
Vol 10 (22) ◽  
pp. 5354
Author(s):  
Anna Małgorzata Kucharska ◽  
Ewelina Witkowska-Sędek ◽  
Małgorzata Rumińska ◽  
Beata Pyrżak
Keyword(s):  
Growth Hormone ◽  
Thyroid Hormone ◽  
Thyroid Function ◽  
Hormone Receptors ◽  
Recombinant Human Growth Hormone ◽  
Human Growth ◽  
Hormone Deficiency ◽  
Central Hypothyroidism ◽  
Rhgh Therapy ◽  
The Impact

The alterations in thyroid function during recombinant human growth hormone (rhGH) treatment have been reported by many authors since this therapy became widely available for patients with growth hormone deficiency (GHD). Decrease of thyroxine level is the most frequent observation in patients treated with rhGH. This paper presents literature data describing changes in thyroid function related to rhGH therapy and a current explanation of mechanisms involved in this phenomenon. The effect of GH on the hypothalamic-pituitary-thyroid (HPT) axis is dependent on a multilevel regulation beginning from influence on the central axis, thyroid, and extra-thyroidal deiodinases activity as well as the impact on thyroid hormone receptors on the end. Changes in central and peripheral regulation could overlap during rhGH therapy, resulting in central hypothyroidism or an isolated slight deficiency of thyroxine. The regular monitoring of thyroid function is recommended in patients treated with rhGH and the decision of levothyroxine (L-thyroxine) supplementation should be made in the clinical context, taking into account thyroid hormone levels, as well as the chance for satisfactory growth improvement.

scholarly journals Immunity and inflammation: the neglected key players in congenital heart disease?

2021 ◽  
Author(s):  
Laura M. Wienecke ◽  
Sarah Cohen ◽  
Johann Bauersachs ◽  
Alexandre Mebazaa ◽  
Benjamin G. Chousterman
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Chronic Inflammation ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Treatment Options ◽  
Open Heart Surgery ◽  
Genetic Alterations ◽  
Immune Alterations ◽  
The Impact

AbstractAlthough more than 90% of children born with congenital heart disease (CHD) survive into adulthood, patients face significantly higher and premature morbidity and mortality. Heart failure as well as non-cardiac comorbidities represent a striking and life-limiting problem with need for new treatment options. Systemic chronic inflammation and immune activation have been identified as crucial drivers of disease causes and progression in various cardiovascular disorders and are promising therapeutic targets. Accumulating evidence indicates an inflammatory state and immune alterations in children and adults with CHD. In this review, we highlight the implications of chronic inflammation, immunity, and immune senescence in CHD. In this context, we summarize the impact of infant open-heart surgery with subsequent thymectomy on the immune system later in life and discuss the potential role of comorbidities and underlying genetic alterations. How an altered immunity and chronic inflammation in CHD influence patient outcomes facing SARS-CoV-2 infection is unclear, but requires special attention, as CHD could represent a population particularly at risk during the COVID-19 pandemic. Concluding remarks address possible clinical implications of immune changes in CHD and consider future immunomodulatory therapies.

scholarly journals Assessment of the performance of the Brazilian Portuguese Nottingham Health Profile in adult growth hormone deficiency and pulmonary hypertension

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 1399
Author(s):  
Alice Heaney ◽  
Rafael W. R. de Oliveira ◽  
Mariana Bizzi ◽  
Ricardo Amorim Correa ◽  
Monica Corso Pereira ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Pulmonary Hypertension ◽  
Growth Hormone Deficiency ◽  
Nottingham Health Profile ◽  
Hormone Deficiency ◽  
Health Profile ◽  
Adult Growth Hormone Deficiency ◽  
Adult Growth ◽  
The Impact ◽  
Disease Specific

Background: The Nottingham Health Profile (NHP) is a generic measure of perceived distress that has been used widely as an outcome measure in clinical practice and trials. The availability of two Brazilian datasets provided the opportunity to assess the psychometric performance of the NHP in different populations - adult growth hormone deficiency (GHD) and pulmonary hypertension (PH). The purpose of the study was to see how valuable the NHP could be in assessing outcomes in diseases where no disease-specific measures are available. Methods: Secondary analyses were performed with NHP data. Patients diagnosed with adult GHD or PH were administered the NHP during clinic visits on two occasions, two weeks apart. A disease-specific measure of quality of life (QoL) was also administered to the relevant sample of patients on each occasion. Results: The psychometric properties of the NHP were good for both disease groups. As expected, both samples reported high scores on energy level, the PH sample scored high on physical functioning and the GHD sample on emotional reactions. For both samples, most of the NHP sections were able to distinguish between groups of respondents with different ratings of perceived general health. While most sections of the NHP were relatively highly correlated with the QoL measures, pain and sleep did not seem to be important predictors of QoL in either of the samples. Conclusions: The use of the NHP in adult GHD and PH populations in Brazil is not recommended as there are high-quality disease-specific measures available for each disease. However, where no disease-specific measures are available, the NHP can provide good descriptive information of the impact of disease on different patient populations.

scholarly journals Three years of growth hormone therapy in children born small for gestational age: results from the ANSWER Program

2018 ◽  
Vol 7 (10) ◽  
pp. 1096-1104 ◽  
Author(s):  
Robert Rapaport ◽  
Peter A Lee ◽  
Judith L Ross ◽  
Paul Saenger ◽  
Vlady Ostrow ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Short Stature ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Growth Failure ◽  
Hormone Deficiency ◽  
Birth Size ◽  
Growth Disorders ◽  
Gh Therapy ◽  
The Impact

Growth hormone (GH) is used to treat short stature and growth failure associated with growth disorders. Birth size and GH status variably modulate response to GH therapy. The aim of this study was to determine the effect of birth size on response to GH therapy, and to determine the impact of GH status in patients born small for gestational age (SGA) on response to GH therapy. Data from the prospective, non-interventional American Norditropin Studies: Web-Enabled Research (ANSWER) Program was analyzed for several growth outcomes in response to GH therapy over 3 years. GH-naïve children from the ANSWER Program were included in this analysis: SGA with peak GH ≥10 ng/mL (20 mIU/L), SGA with peak GH <10 ng/mL (20 mIU/L), isolated growth hormone deficiency (IGHD) born SGA, IGHD not born SGA and idiopathic short stature. For patients with IGHD, those who did not meet criteria for SGA at birth showed greater improvements in height SDS and BMI SDS than patients with IGHD who met criteria for SGA at birth. For patients born SGA, response to GH therapy varied with GH status. Therefore, unlike previous guidelines, we recommend that GH status be established in patients born SGA to optimize GH therapy.

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