Document Detail


From isolated GH deficiency to multiple pituitary hormone deficiency: an evolving continuum - a KIMS analysis.
MedLine Citation:
PMID:  19684053     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe baseline clinical presentation, treatment effects and evolution of isolated GH deficiency (IGHD) to multiple pituitary hormone deficiency (MPHD) in adult-onset (AO) GHD. DESIGN: Observational prospective study. METHODS: Baseline characteristics were recorded in 4110 patients with organic AO-GHD, who were GH naïve prior to entry into the Pfizer International Metabolic Database (KIMS; 283 (7%) IGHD, 3827 MPHD). The effect of GH replacement after 2 years was assessed in those with available follow-up data (133 IGHD, 2207 MPHD), and development of new deficiencies in those with available data on concomitant medication (165 IGHD, 3006 MPHD). RESULTS: IGHD and MPHD patients had similar baseline clinical presentation, and both groups responded similarly to 2 years of GH therapy, with favourable changes in lipid profile and improved quality of life. New deficiencies were observed in 35% of IGHD patients, which was similar to MPHD patients with one additional deficit other than GH. New deficiencies most often presented within the first year but were observed up to 6 years after GH commencement. Conversion of IGHD into MPHD was not predicted by aetiology, baseline characteristics, surgery or radiotherapy, whereas in MPHD additional deficits were predicted by age (P<0.001) and pituitary disease duration (P<0.01). CONCLUSION: Both AO-IGHD and -MPHD patients have similar baseline clinical presentation and respond equally well to 2 years of GH replacement. Hypopituitarism in adults seems to be a dynamic condition where new deficiencies can appear years after the initial diagnosis, and careful endocrine follow-up of all hypopituitary patients, including those with IGHD, is warranted.
Authors:
M Klose; B Jonsson; R Abs; V Popovic; M Koltowska-Häggström; B Saller; U Feldt-Rasmussen; I Kourides
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-08-14
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  161 Suppl 1     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-27     Completed Date:  2009-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  S75-83     Citation Subset:  IM    
Affiliation:
Department of Medical Endocrinology, Copenhagen University Hospital, Rigshospitalet, Denmark. klose@rh.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Age of Onset
Craniopharyngioma / radiotherapy,  surgery,  therapy*
Databases, Factual
Female
Human Growth Hormone / deficiency*,  therapeutic use*
Humans
Hypopituitarism / drug therapy*,  etiology,  metabolism
Male
Middle Aged
Pituitary Hormones / deficiency*,  therapeutic use
Pituitary Neoplasms / radiotherapy,  surgery,  therapy*
Prospective Studies
Risk Factors
Time Factors
Chemical
Reg. No./Substance:
0/Pituitary Hormones; 12629-01-5/Human Growth Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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