Büyüme Hormonu Eksikliğinin Tanı Kriterleri Yeniden Değerlendirilmelidir

Yıl 2012, , 74 - 79, 01.12.2012

Enes Salı Halil Sağlam , Ömer Tarım

https://doi.org/10.4274/Jcp.10.01

Öz

Giriş: Bu çalışmada, hastanemizde büyüme hormonu BH eksikliği tanısıyla izlenençocuklarda tedaviye yanıtı belirleyen etkenlerin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: İzole idyopatik BH eksikliği nedeniyle takip edilen ve BH tedavisikullanan toplam 149 hastanın verileri retrospektif olarak incelendi. Bulgular: Tanı aşamasında bakılan ortalama maksimum BH yanıtı klonidin stimülasyontesti için 4,58 ng/ml, glukagon stimülasyon testi için ise 6,01 ng/ml bulundu. OrtalamaBH dozu 0,215 0,18-0,25 mg/kg/hafta olarak belirlendi. BH tedavisi ile boy SDS anlamlıolarak arttı p< 0,05 . Klonidin ve glukagon uyarısına maksimum BH yanıtı ile boyuzaması arasındaki ilişki negatif yönde anlamlı bulundu p< 0,05 . Uyarı testlerineverilen maksimum yanıta göre hastalar 7 ng/ml olarak ayrıldığında,tedaviye en yüksek yanıtın hem klonidin ve hem de glukagon testlerinde 0,05 . Sonuç: Tedaviye erken başlanan, uyarı testlerinde daha düşük BH yanıtı veren ve dahayüksek doz BH verilen hastaların tedaviden daha çok yarar gördüğü saptandı. Bunedenle, BH eksikliği tanı kriterlerinin gözden geçirilmesi gerektiği, uyarı testlerindekabul edilen 10 ng/ml sınırının aşırı tanı konmasına neden olabileceği görüldü. Daha genişserilerde yapılacak araştırmalarda nihai boyların da değerlendirilmesi ile tanıkriterlerinin yeniden belirlenmesi gerektiği vurgulandı

Anahtar Kelimeler

Büyüme hormonu eksikliği, büyüme hormonu tedavisi

Diagnostic Criteria of Growth Hormone Deficiency Needs to be Reevaluated

Öz

In tro duc ti on: In this study, we aimed to investigate the factors that determine responseto growth hormone GH treatment in children with isolated idiopathic GH deficiencytreated in our university hospital. Materials and Methods: The data of 149 patients followed in our university hospital betweenJanuary 1995 and December 2005 were evaluated in patient charts retrospectively. Results: The maximum GH response to clonidine and glucagon stimulation tests was4.58 and 6.01 ng/ml respectively. The mean GH dose was 0.215 0.18-0.25 mg/kg/week.Height SDS significantly increased after the first and second years of GH treatment p< 0.05 . There was a negative correlation between the maximum response tostimulation tests and the response to GH treatment p< 0.05 . When the patients weregrouped according to the maximum response to stimuli as 7 ng/ml,the best response to therapy was observed in the group with the least response 0.05 .Conclusions: Patients who were started treatment at an early age, whose response to GH stimulation tests were lower, andwho were given higher doses benefited more from GH treatment. Therefore, we suggest that the diagnostic criteria for GHdeficiency must be reevaluated and the random cut-off of

Anahtar Kelimeler

Growth hormone deficiency, growth hormone treatment

Kaynakça

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