Detección de déficit de hormona de crecimiento de origen hipotalámico en niños con talla baja

Introduction. The prevalence of growth hormone deficiency (GHD) varies between 1: 3 700 to 1: 10 000 born alive; 85% of them are of hypothalamic origin and responds well when tested with growth hormone-releasing hormone (GHRH) The aim of this study was to establish the frequency of GHD of hypothalamic origin in a group of short stature children. Material and methods. This is a prospective, non-experimental study carried on in a reference hospital in 1-year period. All patients included (n =18) showed a peak of growth hormone (GH) under 10 ng/mL after 2 different stimuli. Patients were re tested with 1 μg/kg of intravenous GRF (1-29) NH2, an analog of GHRH; those with a response greater than 10 ng/mL of GH were considered as GHD of hypothalamic origin. Results. After GRF (1-29) NH2 test 14 patients reached GH serum levels over 10 ng/mL; 11 patients were males, no differences in age, gender, or pubertal development stage (Tanner classification) were observed; none of the cases with pituitary disease had antecedents of neonatal hipoxia while 25% of patients with GHD of hypothalamic origin had it. Conclusions. Hypothalamic disease was more frequent than pituitary failure as a cause of GHD in our cases; neonatal hipoxia was present only in patients with GHD of hypothalamic origin.