Zusammenfassung der Ressource
Yasser is falling behind
- Short Stature
- Causes
- Bone or skeletal disorders
- Rickets
- Achondroplasia
- Chronic diseases
- Asthma
- Celiac disease
- Congenital heart disease
- Cushing disease
- Diabetes
- Hypothyroidism
- Genetic conditions
- Down syndrome
- Noonan syndrome
- Russell-Silver syndrome
- Turner syndrome
- Williams syndrome
- Other reasons
- Growth hormone deficiency
- Pathophysiology
- Causes
- Deficiency of anterior pituitary secretion (panhypopituitarism)
- Failure of somatomedin receptor or GHR response.
- Lack of somatomedin C secretion by liver
- Hypothalamic dysfunction (decreased GHRH)
- Secretion of inactive growth hormone.
- Effects
- Physical parts of the body develop in a reduced rate, but in appropriate proportion
- With panhypopituitary dwarfism --> no puberty or adult sexual functions
- Diagnosis
- History taking
- GHD Criteria
- Clinical presentation
- Delayed growth
- Increased fat
- Short stature
- High pitched voice
- Micropenis
- Milestones of development
- Physical Examination
- Growth Chart
- Height & Weight measurements
- Calculating the expected height
- 1. Add the mother's height and the father's height in either inches or centimeters.
- 2. Add 5 inches (13 centimeters) for boys or subtract 5 inches (13 centimeters) for girls.
- 3. Divide by two
- Expectations
- Turner syndrome
- Down syndrome
- Achondroplasia (dwarfism)
- Rickets
- Signs of hypopituitarism
- Investigations
- Blood Tests for Growth Hormone Deficiency
- Binding protein levels (IGF-I and IGFBP-3).
- Growth hormone stimulation test
- GHRH-arginine test
- Insulin tolerance test (ITT)
- Other Exams and Tests
- DXA scan
- MRI of the brain
- X-ray of the hand
- X-ray of the head
- Management plan
- Pharmacological Therapy
- Recombinant GH
- Administered IM or SC
- Adverse Effects
- Injection-site pain or arthralgias
- Idiopathic intracranial hypertension
- Hyperglycemia may develop
- GH may promote the growth of various types of neoplasms and increase tumor recurrence rates.
- Recombinant Insulin-Like Growth Factor-1
- Patients should be monitored very closely for hypoglycemia
- Growth Hormone-Releasing Hormone
- Sermorelin is administered daily by subcutaneous injection
- Prognosis:
- Child will grow 1 to 2 inches within the first 6 months of starting treatment
- Intrauterine infections
- Risk Factors
- Large familiar group
- Underweight during pregnancy
- Malnutrition