weight wos found to be 11.0 kg, which wos
ot the 10th centile for his age,while his
height of 81 cm wos below the 3rd centile,
well below the normol range for his age.
Dr Serag then performed o physical
exomination. Yosser's present height ond
weight were measured, plotted ond
compored with previous doto from visits
Dr Serag said thot some tests were
needed now to determine the
cause of Yasser's slow growth rate
overnight hospitol stoy for seperate
tests to determine if Yosser wos
producing growth hormone
X-roys were ordered
diagnosed with growth
hormone deficiency
Dr Serog reossures them thot GH treatment
will probobly result in ropid, 'cotch-up'
growth for a period followed by o period of
noimol growth so thot Yosser should ottoin
his genetic qdult height potential
Recombinant hGH Daily, 25-50
μg/kg/day 3-6 months
Technology that allows a DNA fragment from any source to be joined in vitro with a nucleic acid
vector that can replicate autonomously in microorganisms.
Restriction endonuclease Insert into a vector Any piece of DNA (plasmid, viral, yeast, chromosome)
Restriction endonuclease+ligase Transform host cells The colonies produced
primary objectives of the therapy of GHD are
normalization of height during childhood and
attainment of normal adult height
patients who are receiving growth hormone therapy
2-4 times per year. The most important reasons for
follow-up are to monitor growth progress and to
adjust growth hormone dosage.
causes
A severe head injury
A tumor in your head
history of pituitary tumors
Radiation treatments to your brain
Hormonal problems related
to the hypothalamus gland
or pituitary gland
bone age test
Secretion: Somatotrophs cells of anterior pituitary (30 -40% of cells)
Control of secretion: •GH releasing hormone.
•GH inhibiting hormone (Somatostatin).
Normal concentration of growth hormone in plasma is 1.6 to
3.0 ng/ml for adults and 6 ng/ml for children or adolescents
Growth hormone is secreted in a pulsatile pattern
factors
affecting
production
blood glucose levels
aging
obesity
blood free fatty acids
somatomedins
trauma
exercise
deep sleep
TFTs IGF1 and IGF
BP3
Random GH
Brain CT/skull x-ray
Symptoms of GH deficiency
Child's face may appear younger
than children who are the same age
Delayed puberty—but sometimes a
child won't go through puberty
Increased fat around
the face and stomach
Sluggish hair growth
history taking
Height of parents
Calculation of the sex-adjusted
midparental height, also termed
the "target height," helps evaluate
a child's genetic potential.
• Timing of
puberty in
parents
Constitutional delay in growth and maturation
may have a family history. Most mothers can
remember their age at menarche
General health of child:
Exclusion of chronic
disease as the cause of
short stature is imperative.
• Nutritional history:
malnutrition is the most
common cause of short
stature worldwide.
• Previous
growth points
check child's growth
pattern
Height and weight measurement
Proportionality
Pubertal status
growth charts
Reduce mortality and morbidity
among mothers, infants and
pre- school children
Prevent communicable diseases
Early diagnosis and treatment
of the health problems