Objective

Most patients with childhood-onset growth hormone deficiency (CO-GHD) receive treatment with exogenous growth hormone (GH) to facilitate the attainment of their full potential adult height. Recent evidence suggests that continuing GH administration during the transition period between the end of linear growth and full adult maturity is necessary for proper body composition and bone and muscle health, and may also have beneficial effects on metabolic parameters, bone mineral density, and quality of life. The timing of this transition period coincides with the transfer of care from a pediatric to an adult endocrinologist, creating the potential for a care gap as a consequence of losing the patient to follow-up.

Design

An advisory board comprising both pediatric and adult endocrinologists was assembled to address current clinical unmet needs and to collaborate on a structured transitional plan for optimal management of patients with CO-GHD.

Insights/conclusion

The advisors suggest collaborative, multidisciplinary approaches to ensure continuity of care; ongoing testing and monitoring of GHD status into adulthood; and a clearly structured protocol that includes practical guidance for clinicians to establish best practices for transitioning older adolescents with persistent CO-GHD to adult care.

中文翻译：

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成人生长激素缺乏症：优化从儿科到成人服务的护理过渡

客观的

大多数患有儿童期生长激素缺乏症 (CO-GHD) 的患者接受外源性生长激素 (GH) 治疗，以促进达到其全部潜在成年身高。最近的证据表明，在线性生长结束和成年完全成熟之间的过渡期间持续使用 GH 对适当的身体成分和骨骼和肌肉健康是必要的，并且还可能对代谢参数、骨矿物质密度和骨骼质量产生有益影响。生活。这一过渡期的时机恰逢从儿科到成人内分泌学家的护理转移，由于失去患者的随访而造成护理空白的可能性。

设计

组建了一个由儿科和成人内分泌学家组成的咨询委员会，以解决当前未满足的临床需求，并合作制定结构化的过渡计划，以优化 CO-GHD 患者的管理。

见解/结论

顾问们建议采用协作、多学科的方法来确保护理的连续性；对成年期的 GHD 状态进行持续测试和监测；以及一个结构清晰的协议，其中包括临床医生的实用指南，以建立将患有持续 CO-GHD 的老年青少年过渡到成人护理的最佳实践。