Overview Of Growth Hormone Deficiency
Growth hormone deficiency means the pituitary gland does not make enough growth hormones.
Commonly Associated With
Pituitary dwarfism; Acquired growth hormone deficiency; Isolated growth hormone deficiency; Congenital growth hormone deficiency; Panhypopituitarism; Short stature – growth hormone deficiency
Causes Of Growth Hormone Deficiency
The pituitary gland is located at the base of the brain. This gland controls the body’s balance of hormones. It also makes growth hormones. This hormone causes a child to grow.
This condition may be present at birth. The deficiency may be the result of a medical condition. Severe brain injury may also cause this hormone deficiency.
Children with physical defects of the face and skull, such as cleft lip or cleft palate, may have decreased growth hormone levels.
Most of the time, the cause of the deficiency is unknown.
Symptoms Of Growth Hormone Deficiency
Slow growth may first be noticed in infancy and continue through childhood. The pediatrician will most often draw the child’s growth curve on a growth chart. Children with this deficiency have a slow or flat rate of growth. The slow growth may not show up until a child is 2 or 3 years old.
The child will be much shorter than most children of the same age and sex. The child will still have normal body proportions but maybe chubby. The child’s face often looks younger than other children of the same age. The child will have normal intelligence in most cases.
In older children, puberty may come late or may not come at all, depending on the cause.
Exams & Tests
A physical exam, including weight, height, and body proportions, will show signs of slowed growth and growth hormone deficiency. The child will not follow the normal growth curves.
A hand x-ray can determine bone age. Normally, the size and shape of bones change as a person grows. These changes can be seen on an x-ray and they most often follow a pattern as a child grows older.
Testing is most often done after the pediatrician has looked into other causes of poor growth.
Tests that may be done include:
- Insulin-like growth factor 1 (IGF-1) and insulin-like growth factor-binding protein 3 (IGFBP3). These are substances that growth hormones cause the body to make. Tests can measure these growth factors. Accurate testing involves a stimulation test. This test takes several hours.
- MRI of the head can show the hypothalamus and pituitary glands.
- Tests to measure other hormone levels may be done, because a lack of growth hormone may not be the only problem.
Treatment Of Growth Hormone Deficiency
Treatment involves growth hormone shots (injections) given at home. The shots are most often given once a day. Older children can often learn how to give themselves the shot.
Treatment with growth hormone is long-term, often lasting for several years. During this time, the child needs to be seen regularly by the pediatrician to ensure the treatment is working. If needed, the health care provider will change the dosage of the medicine.
Serious side effects of growth hormone treatment are rare. Common side effects include:
- Headache
- Fluid retention
- Muscle and joint aches
- Slippage of the hip bones
