Growth hormone deficiency can also result from damage to the part of the brain controlling the pituitary gland, the pituitary itself, or both. Some tumours are benign, i.e. not cancerous, and the one that is the most common in the pituitary region is called a craniopharyngioma. This is not technically a brain tumour at all, but part of a piece of mouth epithelium (the lining of the mouth) pinched off and left behind during the development of a baby while still in the womb. A craniopharyngioma can be identified by taking a skull-ray, MRI or by computer assisted tomography of the brain. They are usually surgically removable. Occasionally, they recur, but are removable again.
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Roberts Story
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Growth Hormone Deficiency
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' X" ~+ u; N" YAdults with growth hormone deficiency may require growth hormone treatment for metabolic reasons after they have stopped growing. The daily doses are usually much lower than those given to children. The lack of growth hormone may contribute to symptoms of general tiredness, weakness and weak bones (osteoporosis). Growth hormone is an approved treatment for adult GHD.
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, v& s+ E; T5 bEvery child who has had oncology treatment is a possible candidate for growth hormone.
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" r/ o ~3 R7 M$ `, o3 f. P; f/ oFor further reading, please see the following CGF Booklets;
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Growth Hormone Deficiency. A Guide for Patients and Parents Puberty and the Deficient Child Growth Hormone Deficiency in Adults Emergency Information Pack Multi Pituitary Hormone Deficiency Thyroid Disorders. A Guide for Patients and Parents
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Growth Hormone Deficiency Congenital Adrenal Hyperplasia Growth Hormone Deficiency In Adults MultiPituitary Hormone Deficiency Craniopharyngioma
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Experiences Of Being GHD
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7 L( {, d- ], U j: mGrowth Hormone Deficiency (GHD) is generally due to the pituitary gland being unable to produce sufficient GH to generate the growth process. GHD does not affect intrauterine growth, at least to an extent measurable by birth weight or length, but from the second year of life growth is slower than normal and occasionally growth failure commences from birth. Most cases of growth hormone deficiency are idiopathic, meaning of unknown origin. Idiopathic growth hormone deficiency occurs, it seems, in about 1 in 3800 births.
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R* D% T7 _$ D0 }4 xIf there is a deficiency of TSH, thyroxine is given, and if gonadotrophin deficiency becomes apparent at the time of puberty (which is usually late in growth hormone deficient children), the sex hormones have also to be given and treatment can initiate sexual maturation. Very occasionally antibodies develop to the injected growth hormone treatment and cancel out the effects of treatment but this is extremely rare with more modern biosynthetic human growth hormones; otherwise side-effects are unusual.
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. t& u0 F8 c9 f# W, x2 \2 M% U! HPersonal Stories
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The Child Growth Foundation © 2009 • Registered Charity No 274325 Home | Disclaimer | Site Map | Contact Us
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' H+ o/ r3 {) t T Diagnosis: If MPHD (see below) at birth. If solely GHD possible by 18 months. 80% of cases of GHD should be diagnosed by school entry. Treatment: Growth hormone (GH) replacement therapy
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Further Reading
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! U. V, D6 L2 R8 e0 V" K thyroid-stimulating hormone (TSH) the gonadotrophins - follicle stimulating hormone (FSH) and lutenising hormone (LH) adrenal-stimulating hormone (ACTH) is much less frequently involved, but the deficiency of this hormone is extremely important to detect.
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/ w! S( c/ b$ C7 f8 c3 O4 lThe treatment of growth hormone deficiency has been recognised since the first patient was given human growth hormone by Raben in 1958 in Boston, USA, although since October 1985, biosynthetic growth hormone has replaced the pituitary derived hormone in the UK. Provided treatment is started at a reasonably early age (at least before age 6 years) the results are nearly always excellent (even at later stages results are sometimes spectacular, but not invariably). Catch-up-growth occurs following initial treatment and thereafter a normal growth rate is usually maintained.
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The two main endocrine disorders that cause short stature are growth hormone deficiency and thyroid deficiency.
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, m" K: X: e$ x6 c7 _$ RShort stature is more usually caused by late onset of hypothyroidism, the type of hypothyroidism that starts during childhood, often subtly. The catch-up growth during thyroid hormone replacement treatment is marked but, unfortunately, rarely complete.
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Cheap GHD, at least in some cases. About 3% of children with GHD have brothers or sisters who also have the disorder. In a very few families one of the parents is affected. The deficiency is two to three times more common in boys than in girls, for reasons quite unknown
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Hypothyroidism
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, g4 |3 K: A) j: m- D( [4 A' u, M1 IHome The Foundation Conditions Forums Personal Stories Contact About Us Membership Forums Donations Annual Report Christmas Cards Growth Hormone Deficiency Multi Hormone Pituitary Deficiency PSM/Precocious Puberty IUGR/Russell Silver Sotos Syndrome Turner Syndrome Bone Dysplasia CGF Booklets Home RSS/IUGR/SGA Sotos Syndrome MPHD/GHD PSM/Precocious Puberty Bone Dysplasia Turner Syndrome Annual Convention General GHD/MPHD Anthony's Story Experiences of being GHD Robert's Story IUGR/RSS Emily and RSS/IUGR Georgia's Story Max's Story Sotos Syndrome Jacob's Story My Sister with Sotos Turner Syndrome Anna's Story Katherine and Turner's The X Factor Victoria and Turner's Bone Dysplasia Seb and Bone Dysplasia Contact Us Useful Contacts Endocrine Gland Disorders
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* B2 w" Q+ i% x1 {- Z6 rMost, though not all, have growth hormone deficiency. They are treated with growth hormone, often in conjunction with thyroxine, cortisol (hydrocortisone) and, at the time of puberty, gonadotrophins or sex hormones. In addition such children may need replacement of the posterior pituitary hormone, vasopressin, in order to restore a normal fluid balance in the body.
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" F: S% l v6 P/ A8 T& p- X$ p- J; i Diagnosis: Congenital at birth. Late onset at any age during childhood Treatment: Thyroxine tablets
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4 F ] C5 |5 d2 Q* V1 U# JLack of thyroid gland secretion (thyroxine) may also stop normal growth occurring, as all cells need a certain level of thyroid hormone in them in order to function properly. Hypothyroidism may start in utero, in which case the development of the brain is affected and diagnosis and treatment directly after birth is a matter of urgency. The condition can be diagnosed by measuring the levels of thyroid hormone in the blood and this is now a routine screening test for all new-borns.
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The child with a pituitary tumour occasionally comes to the physician with the sole complaint of short stature, but more usually the symptoms are neurological e.g. headaches, nausea, affected vision. Treatment may involve radiotherapy and / or surgical removal of the tumour after which the child may develop a combination of pituitary hormone deficiencies.
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1 V7 m1 ^. M7 B( XTypical Growth Chart for Idiopathic Hypothyroidism
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4 o6 H4 s: w; b( T: DTypical Growth Chart for Acquired Hypothyroidism
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Children with
GHD are small with normal skeletal proportions, facial appearance and intelligence. They tend to be overweight (this reduces during GH treatment) and they often have a delayed bone age. The diagnosis is confirmed by measuring the level of growth hormone production in response to a stimulation test which normally requires a morning in hospital. The deficiency may be of growth hormone only, although other pituitary hormones may also be affected (MPHD). The associated hormone deficiencies are:
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