Growth hormone deficiency history and symptoms
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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.