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Growth hormone deficiency occurs when the pituitary gland, an area located in the brain responsible for controlling the body’s hormone balance, is not producing enough growth hormone. This results in an abnormally short height in children because as growth hormone enters the blood, it stimulates the liver to produce a hormone called insulin-like growth factor (IGF-1), a hormone critical for childhood growth.
Most of the time, the cause of growth hormone deficiency is unknown.
It may be present at birth (congenital) or develop as the result of an injury, such as a severe brain injury, or medical condition.
Slow growth may first be noticed during infancy and will also continue throughout childhood, but it also may not be noticed until age 2-3. This may cause puberty to occur later or not at all. Children with growth hormone deficiency still have normal body proportions, as well as normal intelligence. However, their face often appears younger than children of the same age. They may also have a chubby body build.
Although it is uncommon, growth hormone deficiency may also be diagnosed in adults. Possible causes include: tumors of the pituitary gland or hypothalamus, brain radiation treatment, severe head injury
Diagnosis and Testing
- • A physical examination including: weight, height, and body proportions
- • Hand x-ray can be used to determine bone age
- • Dual energy x-ray absorptiometry (DEXA) scans can also help determine bone age
- • Growth hormone causes the body to make insulin-like growth factor (IGF1) and insulin-like growth factor binding protein 3 (IGFBP3). Blood tests can measure these growth factors.
- • MRI of the head to examine the hypothalamus and pituitary glands.
- • Additional tests may be required to measure other hormones to determine if other deficiencies are an issue.
Early treatment leads to better outcomes and a stronger chance the child will reach near normal adult height and weight. The mainstay of treatment is growth hormone injections that are typically administered daily. This treatment will last several years and require regular follow up. Common side effects include: headache, fluid retention, muscle and joint pain, and slippage of hip bones.
National Institutes of Health. Growth Hormone. http://www.nlm.nih.gov/medlineplus/ency/article/001176.htm. Accessed May 7, 2015.
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