hyposomatotropism (growth hormone deficiency)
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Etiology
- congenital
- acquired
- most common pituitary disorder after traumatic brain injury, neurosurgical intervention for pituitary tumor, or cranial irradiation[1]
- isolated, idiopathic adult-onset GH deficiency is rare[1]
- component of hypopituitarism
- functional: emotional deprivation syndrome
Clinical manifestations
- children
- adults
- decreased muscle mass
- decreased muscle strength is common
- increased adipose tissue
- diminished bone mineral density
- diminished endurance is common
- diminished sense of well being
- decreased muscle mass
Laboratory
- serum IGF1[1]
- growth hormone stimulation test
- serum growth hormone levels are pulsatile & undetectable for much of the day in most patients[1]
- see ARUP consult[2]
Management
- adults: start human growth hormone 200-300 ug SQ QD
- increment by 200 ug at monthly intervals
- adjust to maintain serum IGF-1 levels in midnormal range
- women receiving oral estrogens require higher doses[2]
More general terms
More specific terms
- growth hormone deficiency isolated type 1A; pituitary dwarfism I (IGHD1A)
- growth hormone deficiency isolated type 1B; dwarfism of Sindh (IGHD1B)
- growth hormone deficiency isolated type 2; dwarfism of Sindh (IGHD1B)
References
- ↑ Jump up to: 1.0 1.1 1.2 1.3 1.4 Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018.
- ↑ Jump up to: 2.0 2.1 2.2 ARUP Consult: Growth Hormone Deficiency The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/growth-hormone-deficiency
- ↑ Kreitschmann-Andermahr I, Poll EM, Reineke A et al Growth hormone deficient patients after traumatic brain injury-baseline characteristics and benefits after growth hormone replacement-an analysis of the German KIMS database. Growth Horm IGF Res. 2008 Dec;18(6):472-8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18829359