Causes and risk factors
GH deficiency can be congenital or acquired. Congenital causes include mutations of specific genes. Acquired causes such as damage to pituitary gland can also lead to the disease. Chronic renal insufficiency can cause deficiency of growth hormone. Tumors of hypothalamus or pituitary gland can lead to the disorder.
Clinical presentation
Patient presents with slow rate of growth. It is seen in infancy and continues through childhood. The child is shorter in height than same sex peers. He will have normal proportion of body parts. The child’s face looks younger than other children of same age. Intelligence is not hampered. The child has fat near the abdomen. There are developmental delays. Puberty may be late in these children.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. There is a clinical test where insulin is injected through IV and GH is measured about 30 minutes later. Levels less than 10 mcg/ml in children raise a suspicion for GH deficiency. Other tests include x-ray of hand to study if the growth plate has fused. Blood test, hormonal test [GH levels for – insulin like growth factor IGF and insulin like growth factor binding protein IGFBP]. Kidney and thyroid function test are done. MRI of head is recommended for viewing hypothalamus and pituitary gland.
Treatment
Treatment involves administration of growth hormone as an injectable, typically into the body’s fatty tissues, such as the back of the arms, thighs, or buttocks.
Other Modes of treatment
The other modes of treatment can also be effective in treating deficiency of growth hormone.
Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating deficiency of growth hormone.
