Growth Hormone Deficiency in Children

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Growth hormone deficiency is the most common pituitary hormone deficiency and is associated with poor overall physical development and short stature.

Other symptoms of growth hormone deficiency depend on the age of the child and the cause of the deficiency.

Most often, doctors do not find the cause of growth hormone deficiency, but sometimes it is caused by a congenital disorder or a brain tumor.

Diagnosis is based on physical examination, developmental charts, and tests, which may include x-rays, blood tests, genetic tests, stimulation tests, and imaging tests.

Treatment usually involves hormone replacement therapy.

Pituitary gland: Main gland

The pituitary gland, a pea-sized gland located at the base of the brain, produces several types of hormones. Each of these hormones affects a specific part of the body (target organ or target tissue).

Location of the Pituitary Gland

If the pituitary gland does not produce enough growth hormone, it can lead to an abnormally low growth rate and short growth with normal proportions. Children with growth hormone deficiency may also be deficient in other pituitary hormones, such as thyroid-stimulating hormone, adrenocorticotropic hormone, follicle-stimulating hormone, and luteinizing hormone (a condition called hypopituitarism ).

Short stature is defined as being below the 3rd percentile for a child’s age (based on standard growth charts for age and height). In addition to growth hormone deficiency, short growth can be explained by other reasons. For example, most children and adolescents are short because their family members are short, or because they have a growth spurt at the very end of the normal range of time for such development. Some children have short stature due to poor weight gain and poor nutrition, or because they have certain chronic conditions that affect the thyroid, heart, lungs, kidneys, or intestines. Other children suffer from genetic diseases that affect bone growth.

The cause of growth hormone deficiency is often unknown, but about 25% of cases have a specific cause, including:

  • congenital diseases
  • tumors or trauma to the brain
  • radiation therapy
  • Infections (such as meningitis and tuberculosis).

Growth Hormone Deficiency Symptoms

Symptoms of growth hormone deficiency depend on various factors, such as the age of the child and the cause of the deficiency.

Children have a poor overall growth rate, typically less than 5 centimeters per year, and most are short but have normal upper and lower body proportions. Some children may have delayed tooth development or delayed puberty.

Other disorders may occur depending on the cause of growth hormone deficiency. Newborns with growth hormone deficiency may have low blood sugar (hypoglycemia) or other congenital abnormalities such as a small penis (micropenis) in men or facial defects (such as a cleft palate). Children may also have symptoms of other hormone deficiencies, such as hypothyroidism.

  • Diagnosing growth hormone deficiency
  • Physician assessment of growth criteria and medical history causing stunting
  • X-ray examination
  • Blood tests and other laboratory tests
  • Sometimes genetic testing
  • Magnetic resonance imaging
  • Typically stimulation tests

Growth hormone levels in the blood vary greatly. Diagnosis of the causes of growth abnormalities based solely on growth hormone levels is not as reliable as diagnostics based on levels of other hormones. In this regard, doctors make a diagnosis based on the results of a variety of data.

Growth Hormone Replacement Therapy

Children receive synthetic growth hormone injections. Hormone therapy is continued until children reach an acceptable height or until they begin to grow more than 2.5 cm per year. During the first year of treatment, children may grow by 10-12 cm, but individual treatment results may vary. Children generally do not have the side effects of growth hormone therapy, but some develop mild limb edema that usually resolves quickly, or rarely have more serious side effects, such as increased pressure in the brain ( idiopathic intracranial hypertension ) or a problem in the upper part femur, which can manifest as pain in the knee or hip joint ( femoral head epiphysis ).

Growth hormone can also be used to increase the height of children with short stature but normal pituitary function, but the use of this hormone is controversial. Some parents believe that short stature is a disorder but most hgh therapy doctor discourage the use of growth hormone in these children. Regardless of the reason for short stature, pituitary hormone is only effective if used before the growth zones in the long bones become inactive.

If found, brain tumors can be surgically removed, but children are at high risk of hypopituitarism as the pituitary gland can be damaged during surgery. Children with hypopituitarism receive hormone replacement therapy to compensate for the deficiency of hormones.