Growth hormone deficiency classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
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.
Classification
Growth hormone deficiency can be classified by onset into:
- Congenital: infants may show symptoms from the first day but some patients wait until 6 months to show symptoms. Hypoglycemia, neonatal growth failure, neonatal jaundice, and asphyxia are common in these cases. The combination of GHD with gonadotropin deficiency can cause microphallus, cryptorchidism, and severe hypoglycemia. Cnongenital growth hormone deficiency can be classified into three types:
- Growth hormone deficiency IA is autosomal recessive and is characterized by growth retardation in utero. Affected children are small in relation to their siblings. The infant usually has a normal response to administration of human growth hormone (hGH) at first, but then develops antibodies to the hormone and grows into a very short adult.
- Growth Hormone Deficiency IB is also autosomal recessive and is similar to IA. However, there is some growth hormone (GH) present in the child at birth and usually the child continues to respond to GH treatments.
- Growth Hormone Deficiency IIB and III are similar to IB, but IIB is autosomal dominant and III is X-linked.
- The abnormal gene can be inherited from either parent or can be the result of a new mutation in the affected individual.
- Acquired: it may first appear in children or adults. Children with GHD present with severe growth failure, delayed bone age, delayed puberty, immature face with an underdeveloped nasal bridge, frontal bossing, sparse hair growth, and infantile fat distribution. Adults with GHD can be grouped into those who had prior childhood GHD, those who acquire GHD secondary to structural lesions or trauma, and those with idiopathic GHD. Childhood GHD is generally further divided into those with organic causes and those in whom the cause is not known.[1]
- Idiopathic growth hormone deficiency is defined as having a height significantly shorter than the normal population (-2.25 SD), a poor adult height prediction (generally defined by having less than the calculated mid-parental height and no detectable cause for short stature. The clinical and biological presentation of idiopathic growth hormone (GH) deficiency (GHD) varies greatly, demonstrating the variety of its pathogenic features and explaining why it is difficult to diagnose.[2]
References
- ↑ Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Vance ML, Endocrine Society (2011). "Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline". J Clin Endocrinol Metab. 96 (6): 1587–609. doi:10.1210/jc.2011-0179. PMID 21602453.
- ↑ Pinto G, Adan L, Souberbielle JC, Thalassinos C, Brunelle F, Brauner R (1999). "Idiopathic growth hormone deficiency: presentation, diagnostic and treatment during childhood". Ann Endocrinol (Paris). 60 (3): 224–31. PMID 10520414.