Growth hormone deficiency history and symptoms: Difference between revisions
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==== Neonatal symptoms ==== | ==== Neonatal symptoms ==== | ||
* Growth failure can occur during the first months of life but may not be obvious until 6 to 12 months of age.<ref name="pmid1519958">{{cite journal| author=Wit JM, van Unen H| title=Growth of infants with neonatal growth hormone deficiency. | journal=Arch Dis Child | year= 1992 | volume= 67 | issue= 7 | pages= 920-4 | pmid=1519958 | doi= | pmc=1793852 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1519958 }}</ref> | * Growth failure can occur during the first months of life but may not be obvious until 6 to 12 months of age.<ref name="pmid1519958">{{cite journal| author=Wit JM, van Unen H| title=Growth of infants with neonatal growth hormone deficiency. | journal=Arch Dis Child | year= 1992 | volume= 67 | issue= 7 | pages= 920-4 | pmid=1519958 | doi= | pmc=1793852 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1519958 }}</ref> | ||
* Bone age and height age are delayed but | * [[Bone age]] and height age are delayed but at the same age of each other.<ref name="pmid11739421">{{cite journal| author=Pena-Almazan S, Buchlis J, Miller S, Shine B, MacGillivray M| title=Linear growth characteristics of congenitally GH-deficient infants from birth to one year of age. | journal=J Clin Endocrinol Metab | year= 2001 | volume= 86 | issue= 12 | pages= 5691-4 | pmid=11739421 | doi=10.1210/jcem.86.12.8068 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11739421 }}</ref> | ||
* Higher frequency of perinatal asphyxia | * Higher frequency of perinatal [[asphyxia]] | ||
* Neonatal morbidity may include hypoglycemia and prolonged jaundice especially if combined with adrenocorticotropic hormone deficiency. | * Neonatal morbidity may include [[hypoglycemia]] and prolonged [[jaundice]] especially if combined with adrenocorticotropic hormone deficiency. | ||
* Cryptorchidism and hypoplasia of the scrotum | * [[Cryptorchidism]] and hypoplasia of the scrotum may occur. | ||
==== Childhood symptoms ==== | ==== Childhood symptoms ==== | ||
* The single most important clinical manifestation of GHD is growth failure. | * The single most important clinical manifestation of GHD is growth failure. | ||
* | * Growth failure may not be obvious until 6-12 months old. | ||
* Children | * Children present with doll-like fat distribution pattern, immature face with under developed nasal bridge. The voice is infantile, and hair growth is sparse and thin. | ||
* | * [[Developmental milestones]] may be delayed due to [[Muscle weakness|muscle weakness.]] | ||
'''Adult symptoms''' | '''Adult symptoms''' | ||
* Patients with childhood-onset GH deficiency have more severe clinical manifestations than those who develop it as adults.<ref name="pmid11600527">{{cite journal| author=Koranyi J, Svensson J, Götherström G, Sunnerhagen KS, Bengtsson B, Johannsson G| title=Baseline characteristics and the effects of five years of GH replacement therapy in adults with GH deficiency of childhood or adulthood onset: a comparative, prospective study. | journal=J Clin Endocrinol Metab | year= 2001 | volume= 86 | issue= 10 | pages= 4693-9 | pmid=11600527 | doi=10.1210/jcem.86.10.7896 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11600527 }}</ref> | * Patients with childhood-onset GH deficiency have more severe clinical manifestations than those who develop it as adults.<ref name="pmid11600527">{{cite journal| author=Koranyi J, Svensson J, Götherström G, Sunnerhagen KS, Bengtsson B, Johannsson G| title=Baseline characteristics and the effects of five years of GH replacement therapy in adults with GH deficiency of childhood or adulthood onset: a comparative, prospective study. | journal=J Clin Endocrinol Metab | year= 2001 | volume= 86 | issue= 10 | pages= 4693-9 | pmid=11600527 | doi=10.1210/jcem.86.10.7896 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11600527 }}</ref> | ||
* Lean body mass is increased in adults who are deficient in GH and not replaced compared with those who have normal GH secretion.<ref name="pmid2245969">{{cite journal| author=Cuneo RC, Salomon F, Wiles CM, Sönksen PH| title=Skeletal muscle performance in adults with growth hormone deficiency. | journal=Horm Res | year= 1990 | volume= 33 Suppl 4 | issue= | pages= 55-60 | pmid=2245969 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2245969 }}</ref> | * [[Body mass|Lean body mass]] is increased in adults who are deficient in GH and not replaced compared with those who have normal GH secretion.<ref name="pmid2245969">{{cite journal| author=Cuneo RC, Salomon F, Wiles CM, Sönksen PH| title=Skeletal muscle performance in adults with growth hormone deficiency. | journal=Horm Res | year= 1990 | volume= 33 Suppl 4 | issue= | pages= 55-60 | pmid=2245969 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2245969 }}</ref> | ||
* Fractures of the lumbar spine | * Fractures of the lumbar spine are higher than normal persons with a high incidence of [[Osteopenia|osteopenia.]] | ||
* The degree of osteopenia appears to correlate directly with the degree of GH deficiency.<ref name="pmid10372687">{{cite journal| author=Colao A, Di Somma C, Pivonello R, Loche S, Aimaretti G, Cerbone G et al.| title=Bone loss is correlated to the severity of growth hormone deficiency in adult patients with hypopituitarism. | journal=J Clin Endocrinol Metab | year= 1999 | volume= 84 | issue= 6 | pages= 1919-24 | pmid=10372687 | doi=10.1210/jcem.84.6.5742 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10372687 }}</ref> | * The degree of [[osteopenia]] appears to correlate directly with the degree of GH deficiency.<ref name="pmid10372687">{{cite journal| author=Colao A, Di Somma C, Pivonello R, Loche S, Aimaretti G, Cerbone G et al.| title=Bone loss is correlated to the severity of growth hormone deficiency in adult patients with hypopituitarism. | journal=J Clin Endocrinol Metab | year= 1999 | volume= 84 | issue= 6 | pages= 1919-24 | pmid=10372687 | doi=10.1210/jcem.84.6.5742 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10372687 }}</ref> | ||
* Less energetic than normal people of the same age<ref name="pmid2816361">{{cite journal| author=McGauley GA| title=Quality of life assessment before and after growth hormone treatment in adults with growth hormone deficiency. | journal=Acta Paediatr Scand Suppl | year= 1989 | volume= 356 | issue= | pages= 70-2; discussion 73-4 | pmid=2816361 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2816361 }}</ref> | * Less energetic than normal people of the same age<ref name="pmid2816361">{{cite journal| author=McGauley GA| title=Quality of life assessment before and after growth hormone treatment in adults with growth hormone deficiency. | journal=Acta Paediatr Scand Suppl | year= 1989 | volume= 356 | issue= | pages= 70-2; discussion 73-4 | pmid=2816361 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2816361 }}</ref> | ||
'''Cardiovascular risk factors''' | '''Cardiovascular risk factors''' | ||
* Dyslipidemia<ref name="pmid10566630">{{cite journal| author=Bengtsson BA, Abs R, Bennmarker H, Monson JP, Feldt-Rasmussen U, Hernberg-Stahl E et al.| title=The effects of treatment and the individual responsiveness to growth hormone (GH) replacement therapy in 665 GH-deficient adults. KIMS Study Group and the KIMS International Board. | journal=J Clin Endocrinol Metab | year= 1999 | volume= 84 | issue= 11 | pages= 3929-35 | pmid=10566630 | doi=10.1210/jcem.84.11.6088 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10566630 }}</ref> | * [[Dyslipidemia]]<ref name="pmid10566630">{{cite journal| author=Bengtsson BA, Abs R, Bennmarker H, Monson JP, Feldt-Rasmussen U, Hernberg-Stahl E et al.| title=The effects of treatment and the individual responsiveness to growth hormone (GH) replacement therapy in 665 GH-deficient adults. KIMS Study Group and the KIMS International Board. | journal=J Clin Endocrinol Metab | year= 1999 | volume= 84 | issue= 11 | pages= 3929-35 | pmid=10566630 | doi=10.1210/jcem.84.11.6088 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10566630 }}</ref> | ||
* Increased inflammatory markers<ref name="pmid11739438">{{cite journal| author=Sesmilo G, Miller KK, Hayden D, Klibanski A| title=Inflammatory cardiovascular risk markers in women with hypopituitarism. | journal=J Clin Endocrinol Metab | year= 2001 | volume= 86 | issue= 12 | pages= 5774-81 | pmid=11739438 | doi=10.1210/jcem.86.12.8087 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11739438 }}</ref> | * Increased inflammatory markers<ref name="pmid11739438">{{cite journal| author=Sesmilo G, Miller KK, Hayden D, Klibanski A| title=Inflammatory cardiovascular risk markers in women with hypopituitarism. | journal=J Clin Endocrinol Metab | year= 2001 | volume= 86 | issue= 12 | pages= 5774-81 | pmid=11739438 | doi=10.1210/jcem.86.12.8087 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11739438 }}</ref> | ||
* Increase in biochemical markers of endothelial dysfunction<ref name="pmid11549653">{{cite journal| author=Elhadd TA, Abdu TA, Oxtoby J, Kennedy G, McLaren M, Neary R et al.| title=Biochemical and biophysical markers of endothelial dysfunction in adults with hypopituitarism and severe GH deficiency. | journal=J Clin Endocrinol Metab | year= 2001 | volume= 86 | issue= 9 | pages= 4223-32 | pmid=11549653 | doi=10.1210/jcem.86.9.7813 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11549653 }}</ref> | * Increase in biochemical markers of endothelial dysfunction<ref name="pmid11549653">{{cite journal| author=Elhadd TA, Abdu TA, Oxtoby J, Kennedy G, McLaren M, Neary R et al.| title=Biochemical and biophysical markers of endothelial dysfunction in adults with hypopituitarism and severe GH deficiency. | journal=J Clin Endocrinol Metab | year= 2001 | volume= 86 | issue= 9 | pages= 4223-32 | pmid=11549653 | doi=10.1210/jcem.86.9.7813 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11549653 }}</ref> | ||
Revision as of 23:03, 14 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History and Symptoms
Common symptoms of growth hormone deficiency include:
Neonatal symptoms
- Growth failure can occur during the first months of life but may not be obvious until 6 to 12 months of age.[1]
- Bone age and height age are delayed but at the same age of each other.[2]
- Higher frequency of perinatal asphyxia
- Neonatal morbidity may include hypoglycemia and prolonged jaundice especially if combined with adrenocorticotropic hormone deficiency.
- Cryptorchidism and hypoplasia of the scrotum may occur.
Childhood symptoms
- The single most important clinical manifestation of GHD is growth failure.
- Growth failure may not be obvious until 6-12 months old.
- Children present with doll-like fat distribution pattern, immature face with under developed nasal bridge. The voice is infantile, and hair growth is sparse and thin.
- Developmental milestones may be delayed due to muscle weakness.
Adult symptoms
- Patients with childhood-onset GH deficiency have more severe clinical manifestations than those who develop it as adults.[3]
- Lean body mass is increased in adults who are deficient in GH and not replaced compared with those who have normal GH secretion.[4]
- Fractures of the lumbar spine are higher than normal persons with a high incidence of osteopenia.
- The degree of osteopenia appears to correlate directly with the degree of GH deficiency.[5]
- Less energetic than normal people of the same age[6]
Cardiovascular risk factors
- Dyslipidemia[7]
- Increased inflammatory markers[8]
- Increase in biochemical markers of endothelial dysfunction[9]
- High coronary calcium scores (a marker of subclinical atherosclerosis)[10]
References
- ↑ Wit JM, van Unen H (1992). "Growth of infants with neonatal growth hormone deficiency". Arch Dis Child. 67 (7): 920–4. PMC 1793852. PMID 1519958.
- ↑ Pena-Almazan S, Buchlis J, Miller S, Shine B, MacGillivray M (2001). "Linear growth characteristics of congenitally GH-deficient infants from birth to one year of age". J Clin Endocrinol Metab. 86 (12): 5691–4. doi:10.1210/jcem.86.12.8068. PMID 11739421.
- ↑ Koranyi J, Svensson J, Götherström G, Sunnerhagen KS, Bengtsson B, Johannsson G (2001). "Baseline characteristics and the effects of five years of GH replacement therapy in adults with GH deficiency of childhood or adulthood onset: a comparative, prospective study". J Clin Endocrinol Metab. 86 (10): 4693–9. doi:10.1210/jcem.86.10.7896. PMID 11600527.
- ↑ Cuneo RC, Salomon F, Wiles CM, Sönksen PH (1990). "Skeletal muscle performance in adults with growth hormone deficiency". Horm Res. 33 Suppl 4: 55–60. PMID 2245969.
- ↑ Colao A, Di Somma C, Pivonello R, Loche S, Aimaretti G, Cerbone G; et al. (1999). "Bone loss is correlated to the severity of growth hormone deficiency in adult patients with hypopituitarism". J Clin Endocrinol Metab. 84 (6): 1919–24. doi:10.1210/jcem.84.6.5742. PMID 10372687.
- ↑ McGauley GA (1989). "Quality of life assessment before and after growth hormone treatment in adults with growth hormone deficiency". Acta Paediatr Scand Suppl. 356: 70–2, discussion 73-4. PMID 2816361.
- ↑ Bengtsson BA, Abs R, Bennmarker H, Monson JP, Feldt-Rasmussen U, Hernberg-Stahl E; et al. (1999). "The effects of treatment and the individual responsiveness to growth hormone (GH) replacement therapy in 665 GH-deficient adults. KIMS Study Group and the KIMS International Board". J Clin Endocrinol Metab. 84 (11): 3929–35. doi:10.1210/jcem.84.11.6088. PMID 10566630.
- ↑ Sesmilo G, Miller KK, Hayden D, Klibanski A (2001). "Inflammatory cardiovascular risk markers in women with hypopituitarism". J Clin Endocrinol Metab. 86 (12): 5774–81. doi:10.1210/jcem.86.12.8087. PMID 11739438.
- ↑ Elhadd TA, Abdu TA, Oxtoby J, Kennedy G, McLaren M, Neary R; et al. (2001). "Biochemical and biophysical markers of endothelial dysfunction in adults with hypopituitarism and severe GH deficiency". J Clin Endocrinol Metab. 86 (9): 4223–32. doi:10.1210/jcem.86.9.7813. PMID 11549653.
- ↑ Cannavò S, Marini F, Curtò L, Torre ML, de Gregorio C, Salamone I; et al. (2011). "High prevalence of coronary calcifications and increased risk for coronary heart disease in adults with growth hormone deficiency". J Endocrinol Invest. 34 (1): 32–7. doi:10.3275/7076. PMID 20511726.