11351852
Yasser's falling behind
- seemed short for his age
- 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
- 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
- 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.
- 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.
- Recombinant hGH Daily, 25-50
μg/kg/day 3-6 months
- 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
- A severe head injury
- 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
- bone age test
- diagnosed with growth
hormone deficiency
- 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
- Growth hormone is secreted in a pulsatile pattern
- 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
- Control of secretion: •GH releasing hormone.
•GH inhibiting hormone (Somatostatin).
- factors
affecting
production
- blood glucose levels
- aging
- obesity
- blood free fatty acids
- somatomedins
- trauma
- exercise
- deep sleep
- blood glucose levels
- X-roys were ordered
- TFTs IGF1 and IGF
BP3
- Random GH
- Brain CT/skull x-ray
- Brain CT/skull x-ray
- Random GH
- overnight hospitol stoy for seperate
tests to determine if Yosser wos
producing growth hormone
- 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
- Sluggish hair growth
- Increased fat around
the face and stomach
- Delayed puberty—but sometimes a
child won't go through puberty
- Child's face may appear younger
than children who are the same age
- history taking
- Height of parents
- Calculation of the sex-adjusted
midparental height, also termed
the "target height," helps evaluate
a child's genetic potential.
- 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
- 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.
- Height of parents
- • Previous
growth points
- check child's growth
pattern
- check child's growth
pattern
- Height and weight measurement
- Proportionality
- Pubertal status
- Pubertal status
- Proportionality
- Dr Serag said thot some tests were
needed now to determine the
cause of Yasser's slow growth rate
- growth charts
- Dr Serag then performed o physical
exomination. Yosser's present height ond
weight were measured, plotted ond
compored with previous doto from visits
- Reduce mortality and morbidity
among mothers, infants and
pre- school children
- Prevent communicable diseases
- Early diagnosis and treatment
of the health problems
- Early diagnosis and treatment
of the health problems
- Prevent communicable diseases
- differentials for delayed growth
- 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.
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