Growth Hormone Deficiency in the Transitional Age.

Abstract

Transition is the time encompassing the achievement of full height and complete somatic development, representing a period of physical, psychological, and social changes. Considering the beginning of social adaptation, the research of independence, and the desire to manage health conditions, the acceptance of chronic care should be poor. Patients affected by growth hormone deficiency (GHD), characterized by heterogeneity in diagnosis, high comorbidity burden, need for daily injections, and lack of biological markers during follow-up, could have a high drop-out rate. Replacement treatment is meaningful because, even if GHD is not life-threatening, it could represent a risk for long-term metabolic, cardiovascular, bone, and psychosocial complications with, eventually, a reduction in quality of life. Moreover, the diagnosis is not always straightforward, since the studies on stimulation tests are limited, or molecules are lacking, cutoffs are often not validated in transition patients, and follow-up requires attention in specific cases (i.e., cancer survivors). The present review aims to describe the features of GHD during transition, focusing on etiologies, pitfalls in diagnosis, GH replacement therapy, and follow-up issues.