growth hormone deficiency
growth hormone deficiency
Hypopituitarism Endocrinology A condition which affects 1:4000 children; ♂:♀, 3-4:1 Etiology 70% of GHD is idiopathic and attributed to a prenatal insult, possibly due to hypothalamic dysfunction, given that GHD children secrete hGH after stimulation with GH-releasing hormone; GHD is associated with midline CNS and facial defects–eg, cleft lip and cleft palate; hypopituitarism may be linked to hypotelorism or a single giant upper central incisor; other causes include septooptic dysplasia, craniopharyngioma, intrasellar or suprasellar tumor Clinical Infants with intrauterine hypopituitarism may present at birth with hypoglycemic seizures, prolonged jaundice, and, if ♂, micropenis and undescended testes; linear growth rates as slow as 3 cm/yr; 10% with early onset disease have hypoglycemic seizures; 20% have chemical hypoglycemia; GHD children are proportional for age, have a prominant calvarium, and are often overweight for height, with prominant subcutaneous deposits of abdominal fat; they may have delayed puberty; electrolyte imbalances, diabetes insipidus, hypothyroidism are rare in Pts with idiopathic hypopituitarism; skeletal maturation is usually delayed; most have heights for bone age < third percentile Screening Assessment of bone age, x-rays of sella turcica, measure somatomedin C which, if normal virtually excludes GHD; pituitary function testing–provocative tests: maximal GH <7 ng/ml indicates impaired GH secretion; > 10 ng/ml excludes GHD Management GH replacement typically ↑ growth rate to 8-10 cm in first yr of therapy; treatment failure mandates workup for hypothyroidism or GH antibodies. See Septooptic dysplasia.Patient discussion about growth hormone deficiency
Q. does the growth hormone have side effects and what are they?