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'''For patient information, click [[Growth hormone deficiency (patient information)|here]]'''
'''For patient information, click [[Growth hormone deficiency (patient information)|here]]'''
==Overview==
==Overview==
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
*The diagnosis of growth hormone deficiency is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
*There are no established criteria for the diagnosis of [disease name].
 
==Diagnostic Criteria==
==Diagnostic Criteria==
* Diagnosis of growth hormone deficiency is a subject of debate due to high costs and complexity of investigations.
* Several types of evidence are used to diagnose GH deficiency:


Several types of evidence are used to ascertain GH sufficiency or deficiency.
* Body measurements. GH deficiency accounts for only a minority of [[short stature]] among children.
* Auxologic criteria (defined by body measurements)
* Indirect [[hormonal]] criteria ([[IGF]] levels)
* Indirect hormonal criteria (IGF levels from a single blood sample)
* Direct [[hormonal]] criteria (secretory patterns of [[Growth hormone|GH levels]] or responses to [[Growth hormone|GH]] stimulation tests)
* Direct hormonal criteria (measurement of GH in multiple blood samples to determine secretory patterns or responses to provocative testing)
* Response to [[Growth hormone|GH treatment]]
* Response to GH treatment
* Radiological evidence of [[Pituitary disease|pituitary dysfunction]]
* Corroborative evidence of pituitary dysfunction
* Many children and adults may not meet all the diagnostic criteria.
 
* An ideal [[diagnostic test]] cleanly separates people who would benefit from a treatment from those who would not.  
For GH deficiency, as for many other diseases, the practical purpose and effect of these diagnostic criteria is to determine who is to be treated with it. GH deficiency accounts for only a minority of [[short stature]] among children. GH deficiency accounts for an even smaller proportion of [[Fatigue (physical)|fatigability]], [[obesity|excessive fat]], [[osteoporosis|osteopenic bones]], and underdeveloped muscles in adults.  An ideal [[diagnostic test]] cleanly separates people who would benefit from a treatment from those who would not. Unfortunately, none of the criteria listed above do so, not even in various combinations.
 
The common clinical problem is that many children and adults being evaluated meet some, but not all, of the above criteria. Since many children and adults who do not meet all of the diagnostic criteria may receive some of the benefits of treatment, small differences in the diagnostic criteria make large differences in the number of short or tired people diagnosed with deficiency.
 
Because of uncertainties and complexities of diagnosis and the high costs of treatment, diagnosis of growth hormone deficiency has been a more persistent subject of debate and controversy in clinical endocrinology than any other aspect of endocrine diagnosis. It has become a major type of internet fraud ([[HGH quackery]]).
 
 
 
==Diagnostic Criteria==
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
**[criterion 1]
**[criterion 2]
**[criterion 3]
**[criterion 4]
*The diagnosis of [disease name] is based on the [criteria name] criteria, which include
**[criterion 1]
**[criterion 2]
**[criterion 3]
*The diagnosis of [disease name] is based on the [definition name] definition, which includes
**[criterion 1]
**[criterion 2]
**[criterion 3]
OR
*There are no established criteria for the diagnosis of [disease name].


==References==
== References ==
{{Reflist|2}}
{{Reflist|2}}


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Revision as of 16:17, 27 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] For patient information, click here

Overview

  • The diagnosis of growth hormone deficiency is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].

Diagnostic Criteria

  • Diagnosis of growth hormone deficiency is a subject of debate due to high costs and complexity of investigations.
  • Several types of evidence are used to diagnose GH deficiency:
  • Body measurements. GH deficiency accounts for only a minority of short stature among children.
  • Indirect hormonal criteria (IGF levels)
  • Direct hormonal criteria (secretory patterns of GH levels or responses to GH stimulation tests)
  • Response to GH treatment
  • Radiological evidence of pituitary dysfunction
  • Many children and adults may not meet all the diagnostic criteria.
  • An ideal diagnostic test cleanly separates people who would benefit from a treatment from those who would not.

References

Template:WH Template:WS

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