Growth hormone deficiency: Difference between revisions
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==[[Growth hormone deficiency risk factors|Risk Factors]]== | ==[[Growth hormone deficiency risk factors|Risk Factors]]== | ||
There are no established risk factors for growth hormone deficiency. | |||
==[[Growth hormone deficiency screening|Screening]]== | ==[[Growth hormone deficiency screening|Screening]]== | ||
==[[Growth hormone deficiency natural history, complications and prognosis|Natural History, Complications and Prognosis]]== | ==[[Growth hormone deficiency natural history, complications and prognosis|Natural History, Complications and Prognosis]]== | ||
If left untreated, patients with growth hormone deficiency may progress to develop [[Delayed growth;|delayed postnatal growth]], [[Bone age|delayed bone age]], [[delayed puberty]], infantile fat distribution, and infantile voice. Common complications of growth hormone deficiency include [[osteopenia]], [[dyslipidemia]], [[delayed puberty]], and higher mortality rates than normal subjects. Prognosis is generally good with treatment. GH treatment can improve GH-deficient adults symptoms. Since [[Recombinant DNA|recombinant]] DNA–derived growth hormone became available, most children with growth hormone deficiency reach normal adult stature. | |||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 00:01, 17 August 2017
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Growth hormone deficiency Microchapters |
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Differentiating Growth hormone deficiency from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Growth hormone deficiency On the Web |
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American Roentgen Ray Society Images of Growth hormone deficiency |
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Risk calculators and risk factors for Growth hormone deficiency |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Synonyms and keywords:
Overview
Historical Perspective
In the mid-1940s, bovine GH has been purified for the first time then, growth hormone was isolated from the human pituitary gland in 1956. 7700 children in the United States and 27,000 children worldwide were given GH extracted from human pituitary glands. In 1981, Genentech developed the first recombinant human GH.
Classification
Growth hormone deficiency can be classified by nature into congenital type in which infants show symptoms such as hypoglycemia, neonatal growth failure, neonatal jaundice, and asphyxia or acquired type presents with severe growth failure, delayed bone age, delayed puberty.
Pathophysiology
The somatotroph cells of the anterior pituitary gland produce growth hormone. GH best-known effect is increasing body mass. GH causes epiphyseal plate widening and cartilage growth. GH deficiency results in alterations in the physiology of different systems of the body, manifesting as altered lipid metabolism, increased subcutaneous visceral fat, decreased muscle mass. Genetic basis of congenital growth hormone deficiency depends on many genes, for example, POU1F1 gene mutations are the most common known genetic cause of combined pituitary hormone deficiency. Gene deletions, frameshift mutations, and nonsense mutations of GH1 gene have been described as causes of familial GHD.
Causes
Causes of growth hormone deficiency could be congenital or acquired. Congenital causes include genetic mutations in POU1F1, PROP-1, and GH-1 genes. Structural causes can cause growth hormone deficiency such as optic nerve hypoplasia, agenesis of corpus callosum, septo-optic dysplasia, empty sella syndrome, and holoprosencephaly. Acquired causes can cause growth hormone deficiency such as GHD following brain surgery and radiation therapy for brain tumors, central nervous system infection, craniopharyngioma, pituitary adenoma.
Differentiating Growth hormone deficiency from other Diseases
Growth hormone deficiency in children must be differentiated from other diseases that cause short stature in children such as achondroplasia, constitutional growth delay, familial short stature, growth hormone resistance, Noonan Syndrome, panhypopituitarism, pediatric hypothyroidism, psychosocial short stature, short stature accompanying systemic disease, short stature from abuse and neglect, Silver-Russell Syndrome, and Turner Syndrome.
Epidemiology and Demographics
Risk Factors
There are no established risk factors for growth hormone deficiency.
Screening
Natural History, Complications and Prognosis
If left untreated, patients with growth hormone deficiency may progress to develop delayed postnatal growth, delayed bone age, delayed puberty, infantile fat distribution, and infantile voice. Common complications of growth hormone deficiency include osteopenia, dyslipidemia, delayed puberty, and higher mortality rates than normal subjects. Prognosis is generally good with treatment. GH treatment can improve GH-deficient adults symptoms. Since recombinant DNA–derived growth hormone became available, most children with growth hormone deficiency reach normal adult stature.
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | X-Ray Findings | CT-Scan Findings | MRI Findings | Other Diagnostic Studies | Other Imaging Findings
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies