Growth

Growth Hormone Deficiency

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Growth Hormone Deficiency, GH Deficiency, Somatotropin Deficiency

  • See Also
  1. Short Stature
  2. Hypopituitarism
  3. Pituitary Gland
  • Epidemiology
  1. Incidence: 1 in 3,000 to 9,000 children with Short Stature
  • Causes
  1. Congenital
  2. Acquired
    1. Head Trauma
    2. CNS Infection
    3. Birth Trauma
    4. Cranial Radiation Therapy
  • Signs
  • Congenital GH Deficiency (newborns)
  1. Normal size at birth
    1. Subsequently falls off height growth curve
    2. Weight for age is preserved
  2. Episodic Hypoglycemia
  3. Prolonged Neonatal Jaundice
  4. Microphallus
  5. Midline craniofacial abnormalities (e.g. Cleft Lip)
  • Signs
  • Acquired
  1. Children
    1. Normal initial growth until onset of GH Deficiency
    2. Progressive Growth Delay (depending on severity)
  2. Adults
    1. Fatigue
    2. Decreased Muscle mass and strength
    3. Increased visceral fat
    4. Premature atherosclerosis
  • Imaging
  1. Brain MRI
  2. Bone Age Film
    1. Delayed Bone Age
  • Labs (in Consultation with pediatric endocrinology)
  1. Screening
    1. Insulinlike Growth Factor 1 (IGF-1)
    2. Insulinlike Growth Factor binding Protein 3
  2. Diagnosis
    1. Negative Growth Hormone provocation test
    2. Pituitary Function Tests
  • Management
  1. Pediatric Endocrinology referral
  2. Recombinant Growth Hormone injections daily
  • References
  1. (2000) J Clin Endocrinol Metab 92(3): 804-10 [PubMed]
  2. Barstow (2015) Am Fam Physician 92(1): 43-50 [PubMed]
  3. Caro (2025) Am Fam Physician 111(6): 532-42 [PubMed]