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Growth Hormone Deficiency in Childhood

المؤلف:  Norman, A. W., & Henry, H. L.

المصدر:  Hormones

الجزء والصفحة:  3rd edition , p78

2026-06-29

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In childhood, there are many possible causes, both genetic and environmental, of short stature and a slow growth rate. Careful laboratory and clinical evaluations, including measurements of IGF-1 levels, are required to determine whether the cause is a deficiency of growth hormone. If present, GH deficiency may be either congenital (e.g., defective GH or GHRH synthesis or secretion) or acquired (through a tumor or injury to the head). The GH deficiency may be isolated, i.e., GH is the only hormone involved, or there may be disruptions in other pituitary hormones as well. GH deficiency untreated in childhood leads to adults with proportionate extreme short stature.

The true incidence of GH deficiency, most of which is idiopathic (cause unknown) is estimated to be around 1 in 3500 children. The child usually has a normal birth weight, but exhibits growth failure and abnormal facial development during the first two years of life. The objective of treatment with replacement recombinant human GH is to normalize height during childhood. Growth rate is most accelerated during the first year of treatment (the “catch-up” phase) with average rates of 8–10 cm/year. If, thereafter, the growth rate slows too much, then other factors such as hypothyroidism or nutritional factors should be considered.