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==[[Growth hormone deficiency historical perspective|Historical Perspective]]==
==[[Growth hormone deficiency historical perspective|Historical Perspective]]==
In the mid-1940s, [[Growth hormone|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 DNA|recombinant]] human GH.
==[[Growth hormone deficiency classification|Classification]]==
==[[Growth hormone deficiency classification|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.
==[[Growth hormone deficiency pathophysiology|Pathophysiology]]==
==[[Growth hormone deficiency pathophysiology|Pathophysiology]]==
The [[Somatotroph|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 gland|pituitary]] hormone deficiency. Gene deletions, f[[Frameshift mutation|rameshift]] mutations, and [[nonsense mutations]] of ''GH1 gene'' have been described as causes of familial GHD.
==[[Growth hormone deficiency causes|Causes]]==
==[[Growth hormone deficiency causes|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 the corpus callosum|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]].''
==[[Growth hormone deficiency differential diagnosis|Differentiating Growth hormone deficiency from other Diseases]]==
==[[Growth hormone deficiency differential diagnosis|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.
==[[Growth hormone deficiency epidemiology and demographics|Epidemiology and Demographics]]==
==[[Growth hormone deficiency epidemiology and demographics|Epidemiology and Demographics]]==


==[[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==
[[Growth hormone deficiency history and symptoms|History and Symptoms]] | [[Growth hormone deficiency physical examination|Physical Examination]] | [[Growth hormone deficiency laboratory findings|Laboratory Findings]] | [[Growth hormone deficiency x ray|X-Ray Findings]] | [[Growth hormone deficiency CT|CT-Scan Findings]] | [[Growth hormone deficiency MRI|MRI Findings]] | [[Growth hormone deficiency other diagnostic studies|Other Diagnostic Studies]] | [[Growth hormone deficiency other imaging findings|Other Imaging Findings]]
[[Growth hormone deficiency history and symptoms|History and Symptoms]] | [[Growth hormone deficiency physical examination|Physical Examination]] | [[Growth hormone deficiency laboratory findings|Laboratory Findings]] | [[Growth hormone deficiency x ray|X-Ray Findings]] | [[Growth hormone deficiency CT|CT-Scan Findings]] | [[Growth hormone deficiency MRI|MRI Findings]] | [[Growth hormone deficiency other diagnostic studies|Other Diagnostic Studies]] | [[Growth hormone deficiency other imaging findings|Other Imaging Findings]]

Revision as of 21:21, 17 August 2017

Growth hormone deficiency Microchapters

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Laboratory Findings

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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

Classification

Pathophysiology

Causes

Differentiating Growth hormone deficiency from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

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

Case Studies

Case #1

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