Growth Hormone Deficiency (3)

Question 1

What is the Congenital type?

What is the Acquired type?

How does it present?

Answer 1

➊ Disruption to GH-axis at the hypothalamus or pituitary
• Can be due to genetic mutation or conditions where pituitary is underdeveloped

➋ Secondary to infection, trauma, or surgery

➌ • Neonates – Micropenis, Hypoglycaemia, Severe jaundice
• Older infants – Poor growth, Short stature, Delayed puberty

Question 2

Which investigations should be done?

How is it managed?

Answer 2

➊ • GH stimulation test – GH levels checked after giving medication that should stimulate its release e.g. glucagon, insulin.
• MRI Brain for pituitary/hypothalamus pathology

➋ • Daily sub-cut GH (Somatropin) injections
• Close monitoring of height and development