Hypopituitarism during the first year of life. A collaborative Italian study.

Literature data on statural growth effect of growth hormone (GH) treatment of children with GH deficiency (GHD) appears disappointing when treatment h ad late onset. It seems therefore that GH treatment should be started as ea rly as possible, thus requiring early diagnosis. This study was undertaken: 1) to define the main characteristics of early onset GHD which may help th e clinician for early diagnosis; 2) to evaluate the effect of a GH treatmen t on the statural growth of early onset GHD, when treatment is started befo re I year of age. Sixteen children with GHD diagnosed before I year of age were included in the study, all of them received a GH treatment before I ye ar of age and for a minimal duration of 5 years; four had isolated GHD seco ndary to a GH gene deletion (type IA GHD). Based on this series, the main a namnestic and clinical characteristics of early onset GHD are: frequent per inatal pathology, short birth height in more than half of the cases, relati vely elevated birth weight in all cases, poor statural growth with neonatal onset, associated signs (hypoglycemia, special facies, micropenis, cryptor chidism, liver dysfunction). The effect of GH treatment (greater than or eq ual to 5 years) on statural growth was limited and transient in children wi th type IA GHD, and resulted in an incomplete catch-up growth in children w ith sporadic GHD, their mean height remaining significantly below their tar get height. (C) 1998 Elsevier, Paris.