Tratamiento con hormona de crecimiento en pediatría, ¿qué podemos mejorar?

Abstract

ObjectivesTo analyze the age at which treatment with growth hormone (GH) is started in the different indications approved in our country, as well as to assess the response to it and detect points of improvement. Material and methodsA descriptive, observational and retrospective study of pediatric patients receiving GH treatment in December 2020 and monitored in the Pediatric Endocrinology Unit of a tertiary care hospital. ResultsA total of 111 patients (52 females) were included in the study. The mean age at the start of treatment was 6.6 years old, being delayed in all diagnostic groups with respect to what is approved for each indication. The indication for which they most frequently received treatment was GH deficiency (n=60, 54%). In this diagnostic group, there is a predominance of males (39 boys vs 21 girls, and a significantly greater increase in height z score (greater height SDS) is observed in those with early start of treatment compared to those who start late (greater height SDS 0.93 vs 0.6; p<0.05).All diagnostic groups presented a greater height SDS and height velocity. No adverse effects were observed in any patient. ConclusionGH treatment is effective and safe for the approved indications. The age of initiation of treatment is a point to improve in all indications, especially in small for gestational age patients. For this, good coordination between primary care pediatricians and pediatric endocrinologists is essential, as well as specific training to identify early signs of different pathologies.