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.

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Patient discussion about growth hormone deficiency.

Q. does the growth hormone have side effects and what are they?

A. Yes, it does, and not a few. They include, among others, pain in the joints, carpal tunnel syndrome, diabetes, pain at the injection site, problems with the thyroid gland, ear problems and many others. You may read more about side effects of growth hormone treatment (called Mecasermin or Somatropin) here: http://www.drugs.com/ppa/mecasermin.html