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Pediatric Growth Hormone Deficiency Symptoms

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What Does Growth Hormone Do

Understanding Pediatric Growth Hormone Deficiency

Growth hormone acts on many parts of the body to promote growth in children. Its essential for normal growth, muscle and bone strength and distribution of body fat.

Once the growth plates in your bones have fused, GH no longer increases height, but your body still needs GH. After youve finished growing, GH helps to maintain normal body structure and metabolism, including helping to keep your blood glucose levels within a healthy range.

If your body doesnt have enough growth hormone whether as an infant, child or adult it can greatly affect your body, albeit in different ways depending on your age. In infants and children, GHD prevents normal growth. In adults, it causes a variety of issues, including increased body fat and elevated blood sugar levels.

How Boston Childrens Hospital Approaches Growth Hormone Deficiency

We view the diagnosis of growth hormone deficiency as an important first step to treatment and, ultimately, to your childs long-term health and continued growth. You can rest assured knowing your child is in capable hands.

Our compassionate staff includes physician specialists who are experienced in the evaluation, diagnosis, and treatment of growth hormone deficiency. And we are uniquely qualified to determine the best course of care for your child. Our child-centric approach ensures that we care for your child as a child, not just another patient.

Because the chain of events involved in growth hormone deficiency is so complex, our researchers are investigating the different events that can cause a child to have short stature. Not all of these individual defects are well understood or easy to detect with a test, making this research vital to treatment strategies.

Our Division of Endocrinology is one of the world’s leading centers dedicated to caring for children and adolescents with acute and chronic endocrine and metabolic disorders. For children who suffer from growth problems, our dedicated team of doctors, nurses, and other caregivers offer hope for a healthier future.

Symptoms And Signs Of Growth Hormone Deficiency

Manifestations of growth hormone deficiency depend on the patient’s age, the underlying etiology, and the specific hormone deficiencies.

Growth hormone deficiency itself typically manifests as growth failure, sometimes along with delay in tooth development. Height is below the 3rd percentile, and growth velocity is < 6 cm/year before age 4 years, < 5 cm/year from age 4 to 8 years, and < 4 cm/year before puberty. Although of small stature, a child with hypopituitarism retains normal proportionality between upper and lower body segments. Skeletal maturation, assessed by bone age determination, is > 2 years behind chronologic age.

Other abnormalities may be present, depending on the underlying defect, and the child may have delayed or absent pubertal development. Weight gain may be out of proportion to growth, resulting in relative obesity. Neonates who have congenital defects of the pituitary or hypothalamus may have hypoglycemia , hyperbilirubinemia, midline defects , or micropenis, as well as manifestations of other endocrine deficiencies.

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How Is Growth Hormone Deficiency Treated

The treatment for growth hormone deficiency is administration of recombinant human growth hormone by subcutaneous injection once a day. The pediatric endocrinologist calculates the initial dose based on weight, and then bases the dose on response and puberty. The parent is instructed on how to administer the growth hormone to the child at home, rotating injection sites among the arms, legs, buttocks, and stomach. The length of growth hormone treatment depends on how well the childs height responds to growth hormone injections and how puberty affects the growth. Usually, the child is on growth hormone injections until growth is complete, which is sometimes many years.

Doctor’s Notes On Growth Hormone Deficiency In Children

Growth Hormone Deficiency

Growth hormone deficiency is a disorder that occurs when the pituitary gland does not produce enough growth hormone. If there is not enough growth hormone produced, a childs growth will be slower than normal. In adults, low or absent growth hormone can also cause emotional symptoms, such as tiredness and lack of motivation.

  • low growth speed for age and pubertal stage,
  • increased amount of fat around the waist,
  • the child may look younger than other children his or her age,
  • delayed tooth development, and
  • delayed onset of puberty.

Symptoms of growth hormone deficiency in adults include low energy, decreased strength and exercise tolerance, decreased muscle mass, weight gain , anxiety, depression, sadness, changes in social behavior, and thin and dry skin.

What Is the Treatment for Growth Hormone Deficiency in Children?

The treatment of growth hormone deficiency in children is to replace growth hormone with daily injections of synthetic growth hormone. Children with genetic mutations causing the growth hormone deficiency may be treated with synthetic human IGF-1 instead.

These treatments are prescribed by a pediatric endocrinologist who will monitor the childs progress. Injections are commonly done by the parents . Most children begin to see results a few months after the initiation of treatment. Treatments are done until the child has reached the end of puberty.

Side effects of the treatment of growth hormone deficiency are rare but include

  • reactions at the injection site.

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What Is The Future For Our Child

After starting growth hormone, most children begin to grow better. Unfortunately, there are some children who are diagnosed with growth hormone deficiency but do not grow even after getting growth hormone shots. The earlier growth hormone deficiency is diagnosed and treated, the better the chance that the child will grow to their genetic potential. It is important to follow your doctors orders for giving growth hormone shots and try not to miss shots.

What Are The Signs And Symptoms Of Childhood

Signs and symptoms vary depending on the severity of the defect and the childs age and can be difficult to identify.

Babies born with growth hormone deficiency have a normal new-born size and generally show no signs at all, but can have low blood sugar levels or yellowish skin colour, which can be due to causes other than growth hormone deficiency.

In both early and later childhood, growth hormone deficiency is identified as slow growth compared with other children of the same age. . Often, the children look chubbier, shorter and younger for their age. Poor development of the bones in the middle of the face is also a sign of inadequate growth hormone. Body proportions and intelligence remain normal.

Growth hormone deficiency can be associated with deficiencies of one or several other pituitary hormones, for example those that control the thyroid or adrenal glands. Signs and symptoms may also be present because of these additional hormone deficiencies and there are many conditions that can cause poor growth and short stature that have nothing to do with growth hormone deficiency. This can make reaching the correct diagnosis a challenge.

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What Are The Signs And Symptoms Of Growth Hormone Deficiency

The signs and symptoms of growth hormone deficiency vary based on what age you are at the onset of the condition.

Symptoms of growth hormone deficiency in infants and children

Growth hormone deficiency in infants and children results in poor growth. The main sign of GHD in children is slow height growth each year after a child’s third birthday. This means they grow less than about 1.4 inches in height a year.

Other symptoms of GHD in children and infants include:

  • A younger-looking face than whats expected for their age.
  • Impaired hair and nail growth.
  • Delayed tooth development.
  • Low blood sugar levels in infants and toddlers.

Symptoms of adult-onset growth hormone deficiency

Symptoms of adult-onset GHD can be more difficult to detect. Symptoms include:

What Are The Different Kinds Of Growth Hormone Deficiency

Signs and Symptoms of Growth Hormone Deficiency

There are three main types of growth hormone deficiency , including:

  • Congenital GHD: Congenital GHD means its present from birth due to a genetic mutation or structural issues in the babys brain.
  • Acquired GHD: GHD is considered to be acquired if its onset is later in life as a result of damage to your pituitary gland. Children and adults can have acquired GHD.
  • Idiopathic GHD: In the medical world, idiopathic means theres no known cause. Some cases of GHD have an unknown cause.

Growth hormone deficiency is also categorized by the age of onset. It has different symptoms and processes for diagnosis if youre a child or adult when the condition begins.

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What Causes Childhood

A child can be born with this defect or acquire it later on in life .

Congenital growth hormone deficiency , can be due to defects in some of the genes involved with the production or the action of growth hormone or due to abnormalities in the structure of the brain . It can be also associated other abnormalities such as facial malformations or as part of a syndrome. Sometimes, the cause is not apparent, this is called idiopathic.

A child, similarly to an adult, can also acquire growth hormone deficiency as a result of a brain tumour and its treatment, brain injury, infection or inflammation. See articles on hypopituitarism and adult-onset growth hormone deficiency for more information.

When To See A Doctor

Most children are diagnosed with pediatric growth hormone deficiency because of an initial slow or flat growth chart. Attending each of your childs scheduled well-child appointments with the pediatrician is crucial for monitoring your childs growth and recognizing a problem early.

It can be difficult for parents to notice delayed growth because we see our children every day. That is why an updated growth chart is helpful in spotting slowing of growth and addressing it right away.

There are several possible reasons for a childs short stature besides pediatric growth hormone deficiency. Many other conditions such as celiac disease and decreased nutritional intake can cause similar symptoms. If you are concerned about your childs growth, talk with your pediatrician.

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Growth Hormone Deficiency Diagnosis

There are several steps involved in diagnosing growth hormone deficiency, and several other factors to consider.

Family traits. If your child isn’t growing as much each year, it might be because your whole family is shorter than average. Your child may also retain more of their “baby fat” simply because your family carries more weight naturally.

Other health conditions. Other health conditions mimic the low production of growth hormones. Thyroid hormone deficiencies and kidney disease may be the cause of your symptoms. Exploring the possibility of these other conditions may help your doctor make a proper diagnosis.

Health history. Looking at your symptoms, health history, and family health history will paint a more detailed picture. If certain conditions or traits run in your family, it can guide your doctor toward a diagnosis.

Prior surgeries, injuries, or a history of pituitary conditions can prompt your doctor to check your pituitary gland as the source of a deficiency.

Blood tests. A blood test can check your hormone levels, including your growth hormones. Blood tests are usually repeated to monitor hormone levels throughout the course of treatment.

Blood tests for adults are less accurate because your body absorbs growth hormone quickly as it circulates in the blood. A healthy person may show low growth hormone because of this.

What Are The Complications Of Growth Hormone Deficiency

Growth Problems in Children

Left untreated, growth hormone deficiency in children may lead to short stature and delayed puberty.

Despite proper treatment, people with adult-onset growth hormone deficiency have an increased risk of heart disease and stroke. Healthy living, such as eating a balanced diet and participating in routine exercise, can help reduce this risk.

People with adult-onset GHD also have a higher risk of developing osteoporosis. Because of this, they have a higher risk of developing bone fractures from minor injuries or falls. To decrease these risks, its important to have a diet thats rich in calcium and to take vitamin D supplements, as recommended by your healthcare provider.

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What Is The Prognosis For Growth Hormone Deficiency

Growth hormone usually results in an increase in height for growth hormone-deficient individuals, as long as the growth plates have not fused. The reason for the growth hormone deficiency should be understood, and it is important to recheck for growth hormone deficiency when the child is an adult, because some children no longer test as if they are growth hormone deficient when they are fully grown.

Pediatric Endocrine Society/American Academy of Pediatrics Section on Endocrinology Patient Education Committee

for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Are There Any Side

Generally there are few side-effects to the treatment these occur more frequently if the dose is too high. Side-effects can include soreness and lumpiness of the skin at the injection site. Headaches, fluid retention, joint and muscle pains have also been reported. Growth hormone cannot be given to children with untreated cancer. If the patient is concerned about any side-effects, these should be discussed with the endocrinologist or GP.

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What Is Growth Hormone Deficiency

GH deficiency happens when the body does not make enough growth hormone to allow a child to grow at a normal pace.

The two kinds of GH deficiency are:

  • Congenital GH deficiency. This is the kind that some babies are born with. They also can have problems with other hormones. Even though they’re born with the condition, some babies look like they’re growing normally until they are about 6 to 12 months old.
  • Acquired GH deficiency. This happens when the body stops making enough GH to grow normally. It can start at any time in childhood.

What Are The Risk Factors For Growth Hormone Deficiency

What is human growth hormone deficiency and can it be treated in children?

Unfortunately, most cases of growth hormone deficiency arent preventable. Certain risk factors can increase you or your childs likelihood of developing acquired GHD, including:

  • Cancer treatment before reaching adult height.
  • Radiation to your head or brain.
  • Total body irradiation.
  • Surgery to your brain, especially the central region of your brain where your pituitary gland is located.

If any of these risk factors apply to you or your child, its important to talk to your healthcare provider about the signs and symptoms of GHD to look out for.

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Pediatric Growth Hormone Deficiency Market Will Grow At A Cagr Of 1900% In The Forecast Of 2029

The MarketWatch News Department was not involved in the creation of this content.

Sep 19, 2022 –Business intelligence is an indispensable aspect when it comes to accomplish meticulous and wide-ranging market insights and the same is applied for generating Pediatric Growth Hormone Deficiency market research report. This market research analysis gives an examination of various segments that are relied upon to witness the quickest development based on the approximated forecast frame. The report offers CAGR value fluctuation during the forecast period of 2022 2029 for the market. Not to mention, Pediatric Growth Hormone Deficiency market document delivers an in-depth study with respect to present and upcoming opportunities which puts light on the future investment in the market.

Pediatric growth hormone deficiency market is expected to gain market growth in the forecast period of 2022-2029. Data Bridge Market Research analyses the market to account to grow at a CAGR of 19.00% in the above mentioned forecast period.

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Key Market Competitors Covered in the Report

Global Pediatric Growth Hormone Deficiency Market Country Level Analysis

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What Are The Symptoms Of Growth Hormone Deficiency

The primary symptom of growth hormone deficiency is a noticeable slow growth , although the body has normal proportions. The child with growth hormone deficiency may also have:

  • An immature face, meaning he or she looks much younger than his or her peers

  • A chubby body build

  • Impaired hair growth

  • Delayed puberty

It is important to note that growth hormone deficiency does not affect the child’s intelligence, and each child experiences symptoms differently. The symptoms of growth hormone deficiency may resemble other problems or medical conditions. Always consult your child’s doctor for a diagnosis.

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Diagnosis Of Growth Hormone Deficiency

  • Auxologic assessment

  • Imaging studies

Because no single test is 100% effective in eliciting GH release , two GH provocation tests are done . GH levels generally peak 30 to 90 minutes after administration of insulin or the onset of arginine infusion, 30 to 120 minutes after levodopa, 60 to 90 minutes after clonidine, and 120 to 180 minutes after glucagon.

The GH response that is considered normal is somewhat arbitrary. Generally, any stimulated GH level > 10 ng/mL is sufficient to rule out classic GH deficiency. GH deficiency may be considered for responses < 10 ng/mL to two pharmacologic stimuli, but results must be interpreted in the context of auxologic data. Because of the arbitrary nature of thresholds for normal results on provocative GH tests, children with otherwise unexplained short stature and normal provocative GH test results may be considered to have GH deficiency if they meet most of the following criteria:

  • Height > 2.25 standard deviations below the mean for age or > 2 SD below the midparental height percentile

  • Growth velocity < 25th percentile for bone age

  • Bone age > 2 SD below the mean for age

  • Low serum insulin-like growth factor 1 and IGF binding protein type 3 levels

  • Other clinical features suggesting growth hormone deficiency

If diminished GH release is confirmed, tests of secretion of other pituitary hormones and hormones of their target peripheral endocrine glands along with pituitary imaging studies must be done if not done previously.

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