Does GH replacement in children with GHD affect their HPA-axis?

Hypopituitarism and panhypopituitarism are common with Cushing's patients (including children) both before and after surgery. Growth hormone deficiency (GHD) treatment also unmasks HPA-axis insufficiencies with adults . But do children respond the same to GH therapy?

A recent article published in Clinical Endocrinology, Effect of Growth Hormone Deficiency and Recombinant hGH (rhGH) Replacement on the Hypothalamic-Pituitary-Adrenal Axis in Children with Idiopathic Isolated GH Deficiency, may be found for free on Medscape (with signup). The authors decided to see if the HPA-axis of children is affected by GH therapy in a similar way adults with GHD are affected. Adults often have central hypoadrenalism which is unmasked when GHD is treated.

The article concludes, "The present study indicates that rhGH therapy has no effect on the HPA in children with idiopathic isolated GHD," and goes on to say, "a reassessment of adrenal function is not required in patient with idiopathic isolated GHD and normal pituitary MRI, during rhGH therapy. These findings further support the view that only in patients with organic hypothalamic-pituitary disease, rhGH treatment may unmask either a hypoadrenal or a hypothyroid state."

For more information, the Magic Foundation is a great resource to learn about growth hormone deficiency (GHD) for children and adults.