Growth Hormone Deficiency

Question 1

What is this a presentation of?

Short stature, hypoglycaemia, mid-face hypoplasia, central adiposity, neonatal hypoglycaemia, jaundice.

Answer 1

Growth hormone deficiency

Question 2

What is this describing?
Rare but treatable cause of growth failure in children. Isolated/combined with other anterior/posterior pituitary deficiencies.

Answer 2

Growth hormone deficiency

Question 3

What are the two types of growth hormone deficiency?

Answer 3

1. Congenital

2. Secondary (CNS tumours, infection, infiltrative disease, radiotherapy.

Question 4

What conditions is growth hormone deficiency associated with?

Answer 4

1. Family history of growth hormone deficiency
2. CNS tumours
3. Cranial radiotherapy
4. Septo-optic dysplasia

Question 5

How is growth hormone deficiency diagnosed?

Answer 5

1. Low IGF-1
2. TFTs to exclude hypothyroidism
3. Gold standard - poor response to ITT/arginine-GHRH stimulation
4. X-ray wrist for delayed skeletal age
5. MRI brain to rule our tumour
6. Screen for other pituitary hormones deficit

Question 6

What is the management of growth hormones deficiency?

Answer 6

SC growth hormone therapy