Context: It has been reported that patients with multiple pituitary hormone deficiencies (MPHD) achieve a greater final height compared with patients with isolated growth hormone deficiency (IGHD). However, the outcome of patients with permanent GHD has not yet been reported.

Objectives: To evaluate and compare adult height data and the effect of spontaneous or induced puberty after long-term treatment with GH in young adults with either permanent IGHD or MPHD.

Design and setting: This was a retrospective multi-center study conducted in University research hospitals and a tertiary referral endocrine unit.

Patients and Methods: Thirty-nine patients with IGHD (26 M, 13 F) and 49 with MPHD (31 m, 18 F), diagnosed at a median age of 7.7 and 6.9 yr, respectively, were re-evaluated for GH secretion after adult height achievement (median age 17.6 and 19.8 yr). The diagnosis of permanent GHD was based on peak GH levels <3 µg/L after an insulin tolerance test (ITT) or peak GH levels <5 µg/L after two different tests. Fifteen subjects had idiopathic GHD and seventy-three had magnetic resonance imaging (MRI) evidence of congenital hypothalamic-pituitary abnormalities. Height SDS was analyzed at diagnosis, at the onset of puberty (either spontaneous or induced), and at the time of GH withdrawal.

Results: The subjects with IGHD entered puberty at a median age of 12.6 yr (females) and 13.4 yr (males). Puberty was induced at a median age of 13.5 and 14.0 yr, respectively, in males and females with MPHD. Median height SDS at the beginning of puberty was similar in the IGHD and in the MPHD subjects. Total pubertal height gain was similar between patients with IGHD or with MPHD. Median adult height was also not significantly different between IGHD and MPHD patients (males, 168.5 vs. 170.3 cm; females, 160.0 vs. 157.3 cm). The adult height SDS of the IGHD subjects was positively correlated with height at the time of diagnosis and with total pubertal height gain. Conversely, the adult height SDS of the MPHD subjects was positively correlated with both the duration of GH treatment and with height SDS at the time of GHD diagnosis

Conclusions: Adult height in patients with permanent IGHD and spontaneous puberty is similar to adult height in patients with MPHD and induced puberty.