Büyüme Hormonu Eksikliği tanısı alan olguların özelliklerinin değerlendirilmesi

Year 2019, , 173 - 177, 23.08.2019

Meltem Direk , Ceyhun Dizdarer Türkan Günay , İlker Günay

https://doi.org/10.30565/medalanya.504321

Abstract

Amaç: Çocuk Endokrinoloji ve Metabolizma polikliniğinde izlenen büyüme hormonu eksikliği tanısı alan olguların klinik ve laboratuar özellikleri saptanarak bundan sonraki olguların değerlendirilmesinde kullanılmasını amaçladık. 

Yöntemler: Dr. Behçet Uz Çocuk Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi endokrinoloji polikliniğinde büyüme hormonu eksikliği tanısı alan 185 hastanın dosyaları geriye dönük olarak tarandı. Hastaların demografik ve klinik bulguları BH eksikliği tanısına göre dört gruba ayrılarak değerlendirildi. 

Bulgular: Toplam 154 olgu (%83,2) idiopatik büyüme hormon eksikliği (İBHE) tanısı alırken, 16 olgu (%8,6) kombine büyüme hormon eksikliği (KBHE), 13 olgu (%7) Turner sendromu, 2 olgu (%1,1) kronik böbrek yetmezliği tanıları ile büyüme hormonu eksikliği tanısı almıştı. Diğer yandan en sık eşlik eden hormon eksikliği 21 hasta (%11,4) ile TSH eksikliği idi. Hastaların 10’unda (%5,4) iki veya daha fazla sayıda hormon eksikliği bulunmaktaydı. İBHE grubunun %15,6’sında intrakraniyal patolojiler mevcutken KBHE’i grubunun %81,2’sinde intrakraniyal patolojik bulgular bulunmaktaydı. KBHE grubunda uyarı testleri yanıtlarının pik değerleri diğer gruplara göre anlamlı olarak daha düşüktü (p<0,0001) 

Sonuç: Büyüme hormonu eksikliği tanısı alan olguların prognozunu belirleyen en önemli risk faktörü etiyolojik tanı, eşlik eden diğer hormonal ya da kromozomal bozukluklar ve erken tedavidir. 

Keywords

Büyüme hormon eksikliği, boy SDS, Etyoloji

Evaluation of cases with growth hormone deficiency

Abstract

Aim:The purpose of this study was to elicit data concerning the clinical and laboratory features of children with growth hormone deficiency monitored by the Pediatric Endocrinology and Metabolism Polyclinic in order to produce useful information for future cases. 

Methods: The medical records of 185 patients diagnosed with growth hormone deficiency at the Dr. Behçet Uz Pediatrics and Pediatric Surgery Research Hospital Pediatric Endocrinology and Metabolism Polyclinic were examined retrospectively. The subjects were allocated into 4 groups according to the cause of growth hormone deficiency. Demographic and clinical characteristics of the patients were assessed and compared across these groups. 

Results: One hundred and fifty-four patients were diagnosed with idiopathic growth hormone deficiency, 16 (8.6%) with combined growth hormone deficiency, 13 (7%) with Turner’s Syndrome, and 2 (1.1%) with chronic renal failure. On the other hand, the most common accompanying hormone deficiency was TSH deficiency, determined in 21 (11.4%) patients. Two or more hormone deficiencies were present in 10 (5.4%) patients. Intracranial pathologies were present in 15.6% of the idiopathic growth hormone deficiency group and 81.2% of the combined growth hormone deficiency group. Bone age, height SDS, and stimulation test peak responses were significantly lower in the combined growth hormone deficiency group than in the other groups. 

Conclusion: The principal risk factors determining prognosis in cases of growth hormone deficiency are etiology, accompanying hormonal or chromosomal disorders, and early treatment. 

Keywords

Growth hormone deficiency, height SDS, Etiology

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