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Article ; Online: Macimorelin Acetate for the Diagnosis of Childhood-onset Growth Hormone Deficiency.

Henry, Rohan K

TouchREVIEWS in endocrinology

2022 Volume 18, Issue 2, Page(s) 84–85

Abstract: Growth hormone provocation testing forms the cornerstone of the diagnosis of childhood growth hormone deficiency in clinical practice. Despite the widespread use of these tests, various criticisms have been levelled against them, such as the labour- ... ...

Abstract	Growth hormone provocation testing forms the cornerstone of the diagnosis of childhood growth hormone deficiency in clinical practice. Despite the widespread use of these tests, various criticisms have been levelled against them, such as the labour-intensive nature of the tests, their potential for serious adverse effects and their questionable reproducibility. Macimorelin acetate, a ghrelin mimetic approved for the diagnosis of adult growth hormone deficiency, could serve an unmet need in the diagnosis of childhood-onset growth hormone deficiency based on its good tolerability and benign side effect profile.
Language	English
Publishing date	2022-09-08
Publishing country	England
Document type	Editorial
ISSN	2752-5457
ISSN (online)	2752-5457
DOI	10.17925/EE.2022.18.2.84
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Article ; Online: When They're Done Growing, Don't Forget They May Still Need Growth Hormone.

Henry, Rohan K

Metabolic syndrome and related disorders

2021 Volume 19, Issue 5, Page(s) 257–263

Abstract: The effect of the growth hormone (GH) in promoting linear growth is well known; however, less recognized by practitioners especially pediatric, are its metabolic properties. This may be because the deleterious effects of improperly treated or untreated ... ...

Abstract	The effect of the growth hormone (GH) in promoting linear growth is well known; however, less recognized by practitioners especially pediatric, are its metabolic properties. This may be because the deleterious effects of improperly treated or untreated growth hormone deficiency (GHD) can present beyond the pediatric years. In addition, clinicians may lack familiarity with the potential issues that can arise due to inadequately treated GHD. Considering information from both the basic sciences research and clinical medicine, pediatric practitioners should be cognizant about the metabolic effects of GH. They should also be equipped to provide anticipatory guidance to patients regarding the importance of adherence to therapy in GHD and be prepared to transition patients with permanent GHD from pediatric GH supplementation to adult GH dosing. With a lack of proper transitioning, adverse outcomes may present beyond childhood.
MeSH term(s)	Adult ; Child ; Human Growth Hormone/deficiency ; Human Growth Hormone/therapeutic use ; Humans
Chemical Substances	Human Growth Hormone (12629-01-5)
Language	English
Publishing date	2021-02-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2151220-6
ISSN	1557-8518 ; 1540-4196
ISSN (online)	1557-8518
ISSN	1540-4196
DOI	10.1089/met.2020.0130
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Article ; Online: Approach to the Patient: Case Studies in Pediatric Growth Hormone Deficiency and Their Management.

Henry, Rohan K / Miller, Bradley S

The Journal of clinical endocrinology and metabolism

2023 Volume 108, Issue 11, Page(s) 3009–3021

Abstract: Context: Pathologies attributed to perturbations of the GH/IGF-I axis are among the most common referrals received by pediatric endocrinologists.: Aim: In this article, distinctive cased-based presentations are used to provide a practical and ... ...

Abstract	Context: Pathologies attributed to perturbations of the GH/IGF-I axis are among the most common referrals received by pediatric endocrinologists. Aim: In this article, distinctive cased-based presentations are used to provide a practical and pragmatic approach to the management of pediatric growth hormone deficiency (GHD). Cases: We present 4 case vignettes based on actual patients that illustrate (1) congenital GHD, (2) childhood GHD presenting as failure to thrive, (3) childhood GHD presenting in adolescence as growth deceleration, and (4) childhood-onset GHD manifesting as metabolic complications in adolescence. We review patient presentation and a management approach that aims to highlight diagnostic considerations for treatment based on current clinical guidelines, with mention of new therapeutic and diagnostic modalities being used in the field. Conclusion: Pediatric GHD is diverse in etiology and clinical presentation. Timely management has the potential not only to improve growth but can also ameliorate or even mitigate adverse metabolic outcomes, which can be directly attributed to a GH deficient state.
MeSH term(s)	Adolescent ; Child ; Humans ; Dwarfism, Pituitary/therapy ; Dwarfism, Pituitary/drug therapy ; Growth Hormone/metabolism ; Human Growth Hormone/therapeutic use ; Hypopituitarism/diagnosis ; Hypopituitarism/etiology ; Hypopituitarism/therapy ; Insulin-Like Growth Factor I/metabolism
Chemical Substances	Growth Hormone (9002-72-6) ; Human Growth Hormone (12629-01-5) ; Insulin-Like Growth Factor I (67763-96-6)
Language	English
Publishing date	2023-05-27
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgad305
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Article: For Debate: The Two Paths of Growth Hormone (Excess and Deficiency): Both Roads Uniquely Lead to Diabetes Mellitus.

Henry, Rohan K

Pediatric endocrinology reviews : PER

2020 Volume 17, Issue 4, Page(s) 287–292

Abstract: Glucose dysregulation (GD), a feature of growth hormone excess, in the setting of acromegaly is well known by clinicians. However, less well known is that GD may be a feature of growth hormone deficiency. The fact that either ends of the spectrum of ... ...

Abstract	Glucose dysregulation (GD), a feature of growth hormone excess, in the setting of acromegaly is well known by clinicians. However, less well known is that GD may be a feature of growth hormone deficiency. The fact that either ends of the spectrum of growth hormone (excess or deficiency) can be associated with diabetes mellitus is unique and clinicians should especially recognize that impaired glucose tolerance and even diabetes mellitus may develop in individuals predisposed to having growth hormone deficiency.
MeSH term(s)	Acromegaly ; Diabetes Mellitus ; Glucose ; Human Growth Hormone ; Humans
Chemical Substances	Human Growth Hormone (12629-01-5) ; Glucose (IY9XDZ35W2)
Language	English
Publishing date	2020-08-11
Publishing country	Israel
Document type	Journal Article
ZDB-ID	2434390-0
ISSN	1565-4753
ISSN	1565-4753
DOI	10.17458/per.vol17.2020.fd.h.ghdiabetesmellius
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Article ; Online: Childhood growth hormone deficiency, a diagnosis in evolution: The intersection of growth hormone history and ethics.

Henry, Rohan K

Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society

2020 Volume 55, Page(s) 101358

Abstract: In 1958 the first recorded case of a patient treated with human growth hormone for growth hormone deficiency was published. Since that time, the source and availability of human growth hormone have changed. With the increased availability of growth ... ...

Abstract	In 1958 the first recorded case of a patient treated with human growth hormone for growth hormone deficiency was published. Since that time, the source and availability of human growth hormone have changed. With the increased availability of growth hormone, there has been an uptrend in the level below which childhood growth hormone deficiency is diagnosed based on provocative GH stimulation testing. This increase is despite better specificity of growth hormone assays in addition to a lack of supportive evidence regarding appropriate normal values. With these trends the diagnosis of childhood growth hormone deficiency is evolving, and clinicians should be aware that this may have potential ethical implications.
MeSH term(s)	Child ; Diagnostic Tests, Routine/ethics ; Growth Disorders/blood ; Growth Disorders/diagnosis ; History, 20th Century ; History, 21st Century ; Human Growth Hormone/blood ; Human Growth Hormone/deficiency ; Human Growth Hormone/history ; Humans
Chemical Substances	Human Growth Hormone (12629-01-5)
Language	English
Publishing date	2020-10-06
Publishing country	Scotland
Document type	Historical Article ; Journal Article ; Review
ZDB-ID	1436781-6
ISSN	1532-2238 ; 1096-6374
ISSN (online)	1532-2238
ISSN	1096-6374
DOI	10.1016/j.ghir.2020.101358
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Article ; Online: Growth hormone after CNS tumor diagnosis: the fundamentals, fears, facts, and future directions.

Ronsley, Rebecca / Lazow, Margot / Henry, Rohan K

Pediatric hematology and oncology

2023 Volume 40, Issue 8, Page(s) 786–799

Abstract: Growth hormone deficiency (GHD) may occur in pediatric patients with central nervous system (CNS) tumors at initial tumor presentation or later as treatment-related sequelae. While it is well recognized that growth hormone (GH) has beneficial effects on ... ...

Abstract	Growth hormone deficiency (GHD) may occur in pediatric patients with central nervous system (CNS) tumors at initial tumor presentation or later as treatment-related sequelae. While it is well recognized that growth hormone (GH) has beneficial effects on growth and endocrinopathies, there's often hesitancy by clinicians to initiate GH therapy for GHD after CNS tumor diagnosis due to the perceived increased risk of tumor recurrence. The available data is described here and based on this review, there is no evidence of increased risk of tumor recurrence or secondary malignancy in patients treated with GH after CNS tumor diagnosis. Further understanding of tumor biology and presence of downstream GH targets including insulin-like growth factor-1 (IGF-1) and insulin receptor activity is still needed.
MeSH term(s)	Humans ; Child ; Growth Hormone/therapeutic use ; Neoplasm Recurrence, Local ; Insulin-Like Growth Factor Binding Protein 3 ; Human Growth Hormone/therapeutic use ; Insulin-Like Growth Factor I ; Central Nervous System Neoplasms/diagnosis ; Central Nervous System Neoplasms/drug therapy ; Fear
Chemical Substances	Growth Hormone (9002-72-6) ; Insulin-Like Growth Factor Binding Protein 3 ; Human Growth Hormone (12629-01-5) ; Insulin-Like Growth Factor I (67763-96-6)
Language	English
Publishing date	2023-03-20
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	632914-7
ISSN	1521-0669 ; 0888-0018
ISSN (online)	1521-0669
ISSN	0888-0018
DOI	10.1080/08880018.2023.2190765
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Article ; Online: Growth Hormone Deficiency and Nonalcoholic Fatty Liver Disease with Insights from Humans and Animals: Pediatric Implications.

Henry, Rohan K

Metabolic syndrome and related disorders

2018

Abstract: In addition to its growth promoting role, growth hormone (GH) has a significant effect on intermediary metabolism in the well state. Despite the latter fact, pediatric practitioners are usually focused on the growth promoting aspects of GH as opposed to ... ...

Abstract	In addition to its growth promoting role, growth hormone (GH) has a significant effect on intermediary metabolism in the well state. Despite the latter fact, pediatric practitioners are usually focused on the growth promoting aspects of GH as opposed to those metabolic. In recent years various animal and human studies (in adults mainly) and clinical reports in children have repeatedly shown the association of GH deficiency (GHD) and fatty liver disease. Based on this well-identified association, despite a lack of studies involving children, it behooves the pediatric clinician to ensure that not only patients with GHD are appropriately treated but also that adolescents even beyond the period of linear growth should be appropriately transitioned to adult GH therapy should this be appropriate.
Language	English
Publishing date	2018-10-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2151220-6
ISSN	1557-8518 ; 1540-4196
ISSN (online)	1557-8518
ISSN	1540-4196
DOI	10.1089/met.2018.0056
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Article ; Online: Beyond the bias! Sex distribution in paediatric growth hormone deficiency reexamined.

Henry, Rohan K / Mamilly, Leena / Chaudhari, Monika / Klamer, Brett G / Nikahd, Melica / Pyle-Eilola, Amy L

Clinical endocrinology

2024 Volume 100, Issue 5, Page(s) 441–446

Abstract: Objectives: Various biases pertaining to stature account for a male sex predominance in growth hormone deficiency (GHD) cases diagnosed by endocrinology clinics. This manuscript will assess the sex distribution when biases are minimised.: Methods: ... ...

Abstract	Objectives: Various biases pertaining to stature account for a male sex predominance in growth hormone deficiency (GHD) cases diagnosed by endocrinology clinics. This manuscript will assess the sex distribution when biases are minimised. Methods: Retrospective chart review was conducted on patients diagnosed with GHD between 3 and 16 years of age. The sex distribution of cases was ascertained according to: (1) peak GH (pGH) by groups; based on growth hormone provocative testing, (2) pituitary gland imaging results, and (3) isolated GHD (IGHD) versus multiple pituitary hormone deficiencies (MPHD). The relative frequency of each sex was compared according to these subgroups with significance evaluated at α = .05 level. Results: Of the 5880 clinic referrals for short stature, there were 3709 boys (63%) and 2171 girls (37%). Of these, 20% of boys (n = 745) and 15.3% of girls (n = 332) underwent provocative testing for GHD. Of those tested, 39.2% of boys (n = 292) and 32.2% of girls (n = 107) were diagnosed with GHD, all p < .001. There was a male predominance in GHD cases based on pGH or GHD severity. Though not significant, girls were more likely than boys to have MPHD (p = .056), even across pGH groups (p = .06). Both boys and girls had a similar distribution of imaging abnormalities. Conclusion: Stratifying by sex, we found similar percentages of pituitary imaging abnormalities (including tumours) and the number of pituitary hormone deficiencies in boys and girls as the cause of GHD. For these classifications, we did not find the historically reported male sex predominance.
MeSH term(s)	Female ; Humans ; Child ; Male ; Retrospective Studies ; Hypopituitarism/epidemiology ; Human Growth Hormone ; Dwarfism, Pituitary/epidemiology ; Growth Hormone ; Sex Distribution
Chemical Substances	Human Growth Hormone (12629-01-5) ; Growth Hormone (9002-72-6)
Language	English
Publishing date	2024-03-11
Publishing country	England
Document type	Journal Article
ZDB-ID	121745-8
ISSN	1365-2265 ; 0300-0664
ISSN (online)	1365-2265
ISSN	0300-0664
DOI	10.1111/cen.15047
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Article ; Online: The utility of a random cortisol level in determining neonatal central adrenal insufficiency.

Bulan, Ayse / Pyle-Eilola, Amy L / Mamilly, Leena / Chaudhari, Monika / Henry, Rohan K

Clinical endocrinology

2023 Volume 98, Issue 6, Page(s) 779–787

Abstract: Objectives: While it has been established within the first 4 months of life that there is no circadian rhythm, what is unclear is the usefulness of a random serum cortisol (rSC) level in determining neonatal central adrenal insufficiency (CAI). The ... ...

Abstract	Objectives: While it has been established within the first 4 months of life that there is no circadian rhythm, what is unclear is the usefulness of a random serum cortisol (rSC) level in determining neonatal central adrenal insufficiency (CAI). The objective of the study is to determine the utility of using rSC in infants less than 4 months old in the evaluation of CAI. Design and patients: Retrospective chart review of infants who underwent a low dose cosyntropin stimulation test ≤4 months of life with rSC taken as baseline cortisol before stimulation. Infants were divided into three groups: those diagnosed with CAI, those at risk for CAI (ARF-CAI) and a non-CAI group. Mean rSC for each group was compared, and ROC analysis was used to identify rSC cut-off for the diagnosis of CAI. Results: Two hundred and fifty one infants with the mean age of 50.5 ± 38.08 days, and 37% of these were born at term gestation. The mean rSC were lower in the CAI group (1.98 ± 1.88 mcg/dl) as compared to the ARF-CAI (6.27 ± 5.48 mcg/dl, p = .002) and non-CAI (4.6 ± 4.02 mcg/dl, p = .007) groups. ROC analysis identified a cut-off of rSC level of 5.6 mcg/dL is associated with 42.6% sensitivity and 100% specificity for the diagnosis of CAI in term infants. Conclusions: This study demonstrates that though an rSC can be used within the first 4 months of life, its value is best when done ≤30 days of life. Moreover, a diagnostic cut-off for CAI using rSC levels was identified for term infants.
MeSH term(s)	Infant ; Infant, Newborn ; Humans ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Hydrocortisone ; Retrospective Studies ; Sensitivity and Specificity ; Adrenal Insufficiency/diagnosis ; Cosyntropin
Chemical Substances	Hydrocortisone (WI4X0X7BPJ) ; Cosyntropin (16960-16-0)
Language	English
Publishing date	2023-03-20
Publishing country	England
Document type	Journal Article
ZDB-ID	121745-8
ISSN	1365-2265 ; 0300-0664
ISSN (online)	1365-2265
ISSN	0300-0664
DOI	10.1111/cen.14903
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Article: Type 2 Diabetes Mellitus, a Sequel of Untreated Childhood Onset Growth Hormone Deficiency Developing in a 17-Year-Old Patient.

Henry, Rohan K / Menon, Ram K

Case reports in endocrinology

2018 Volume 2018, Page(s) 4748750

Abstract: In a seminal report, a 17-year-old boy with panhypopituitarism had fatty liver (FL) amelioration with growth hormone (GH). By extension, since hepatic insulin resistance (IR) is key to FL and type 2 diabetes mellitus (T2DM), GH then may ameliorate the IR ...

Abstract	In a seminal report, a 17-year-old boy with panhypopituitarism had fatty liver (FL) amelioration with growth hormone (GH). By extension, since hepatic insulin resistance (IR) is key to FL and type 2 diabetes mellitus (T2DM), GH then may ameliorate the IR of T2DM. We present a 17-year-old nonobese female with untreated childhood onset growth hormone deficiency (CO-GHD) who developed type 2 diabetes mellitus (T2DM) and steatohepatitis with bridging fibrosis. Based on height z-score of - 3.1 and a history of radiation therapy as treatment for a medulloblastoma at 7 years of age, GHD was quite likely. GH therapy was, however, not initiated at 15 years of age (when growth was concerning) based on full skeletal maturity. After she developed T2DM, GHD was confirmed and GH was initiated. With its initiation, though insulin dose decreased from 2.9 (~155 units) to 1.9 units/kg/day (~ 100 units), her T2DM was, however, not fully reversed. This illustrates the natural history of untreated CO-GHD and shows that though hepatic IR can be ameliorated by GH, full reversal of T2DM may be prevented with irreversible hepatic changes (fibrosis). Clinicians caring for pediatric patients and otherwise should remember that, even in patients beyond the cessation of linear growth, GH can have a crucial role in both glucose and lipid metabolism.
Language	English
Publishing date	2018-10-24
Publishing country	United States
Document type	Case Reports
ZDB-ID	2627633-1
ISSN	2090-651X ; 2090-6501
ISSN (online)	2090-651X
ISSN	2090-6501
DOI	10.1155/2018/4748750
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