Growth Hormone Deficiency
Also known as: hypopituitarism
What is it?
Growth hormone deficiency (GHD), also known as
hypopituitarism, occurs in children who have a deficient pituitary gland
that secrets inadequate amount of growth hormone. Growth hormone is
usually secreted in response to sleep, exercise, and hypoglycemia and
promotes growth and metabolic function.
Who gets it?
It is estimated that GHD affects 1 in every 4,000
school-age children. GHD occurs three or four times more often among boys
than girls.
What causes it?
Causes of GHD include hypothalamic disorders that impair
secretion of growth hormone, and lesions of the pituitary gland or
pituitary stalk that cause deficiencies. In some cases it is found that
children diagnosed with GHD have developmental defects of the pituitary
gland and hypothalamus, which can be inherited. In addition, 65% of
children who have received radiation therapy for such diseases as leukemia
or middle-ear or nasopharyngeal tumors have deficiencies in growth
hormone. GHD can also occur among children with emotional disturbances
caused by living in hostile and inadequate living environments.
What are the symptoms?
GHD is characterized by a decrease in growth, delay in
skeletal maturation and absence of other explanations for poor growth.
Infants with intrauterine GHD at birth can have hypoglycemic seizures and
prolonged jaundice; boys have micropenis and undescended testes. Growth
failure is often is apparent by the end of the first year, and growth
rates continue to slow during childhood. Children with GHD are normally
proportioned for age, have a prominent skullcap, tend to be overweight for
height, and have prominent deposits of abdominal fat. Many affected
patients do not undergo puberty at the appropriate age because of GHD.
How is it diagnosed?
Children suffering from growth failure are typically
diagnosed by the end of the first year after birth. To diagnose GHD,
previous growth measurements are evaluated, a bone age (x-ray of a child's
hand and wrist) is taken and blood samples are assessed for possible
thyroid hormone deficiency. Testing for GHD will occur when other
possibilities of short stature have been ruled out. A child's growth
hormone secretion will be stimulated and measured over a period of 8-12
hours, since growth hormone secretion varies throughout the day and is
greatest after falling asleep.
What is the treatment?
Once diagnosed with GHD, the patient will
be treated with human growth hormone. Though every child
may not react similarly to growth hormone treatment, the
majority of children treated appropriately will reach
genetically expected adult heights. Growth hormone therapy
is given by injection, either daily or several times per
week, by parents who are trained to give these injections.
Self-care tips
Early diagnosis of GHD is extremely
important for the affected child. To obtain the best
results, a child must be diagnosed and treated at a
relatively young age. Successful treatment must begin
before the child's bones fuse; once fusing has taken
place, no additional growth is possible. Many children
much shorter than their peers experience both physical and
emotional problems. Communicate with your child, offer
assistance when necessary, and remember to treat the child
according to their age, not their size.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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