Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)

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Klose, M. et al.

M. Klose, B. Jonsson, R. Abs, V. Popovic, M. Koltowska-Häggström, B. Saller, U. Feldt-Rasmussen, I. Kourides,

From isolated GH deficiency to multiple pituitary hormone deficiency: an evolving continuum - a KIMS analysis.

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.[1]

References

From isolated GH deficiency to multiple pituitary hormone deficiency: an evolving continuum - a KIMS analysis. Klose, M., Jonsson, B., Abs, R., Popovic, V., Koltowska-Häggström, M., Saller, B., Feldt-Rasmussen, U., Kourides, I. Eur. J. Endocrinol. (2009) [Pubmed]

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