Growth Hormone Deficiency

Question 1

Where is growth hormone produced

Answer 1

Anterior pituitary

Question 2

What causes congenital growth hormone deficiency

Answer 2

Disruption to growth hormone axis at the hypothalamus or pituitary gland.

Question 3

Genetics of growth hormone deficiency

Answer 3

Mutation in GH1 and GHRHR. Or condition such as empty sella syndrome

Question 4

What causes acquired growth hormone deficiency

Answer 4

Secondary to infection, trauma or surgery

Question 5

Presentation of growth hormone deficiency at birth/in neonates

Answer 5

Micropenis, hypoglycaemia or severe jaundice

Question 6

Presentation of growth hormone deficiency in infants and children

Answer 6

Poor growth usually stopping at age 2-3, short stature, slow development of movement and strength, delayed puberty

Question 7

Investigations into growth hormone deficiency

Answer 7

Growth hormone stimulation test - giving glucagon, insulin, arginine and clonidine and GH levels monitored regularly for 2-4 hours after administration. There will be poor response.

Question 8

Additional tests and investigations

Answer 8

Thyroid, adrenals, MRI brain, genetic testing DEXA scan of bones.

Question 9

Treatment of growth hormone deficiency

Answer 9

SC growth hormone injections of somatropin, close monitoring of height and development