scholarly journals Clinical and auxological characteristics of growth hormone deficiency in children of the southern region of Ukraine

2021 ◽  
Vol 25 (1) ◽  
pp. 40-44
Author(s):  
L. I. Senkivska ◽  
M. L. Aryayev
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Gh Deficiency ◽  
Bone Age ◽  
Hormone Deficiency ◽  
P Value ◽  
Organic Basis ◽  
Pituitary Hormone ◽  
Realistic Assessment ◽  
Stimulation Tests

Anotation. Regional clinical and auxological studies of growth hormone deficiency (GHD) in children contribute to a realistic assessment of the severity of the problem and prevent underdiagnostics of the disease. The aim of the study is to analyze the features of various forms of GHD in children of the Odessa region on the basis of the clinicians’ integrated assessment of history, physical examination, auxology, stature, growth velocity, bone age (BA), 2 growth hormone (GH) stimulation tests, insulin-like growth factor, magnetic resonance imaging in 92 children with GHD in the Odessa region. Parametric variables were assessed using criteria t-test and хі-square (χ2). The p value <0,05 was considered statistically significant. Decrease in SDS height from - 2,1 tо - 6,6 was found. Isolated GHD (IGHD) was diagnosed in 65,2% of diseases, multiple pituitary hormone deficiency (MPHD) in 34,8% cases. IGHD was more often idiopathic and MPHD was more often arose on an organic basis. Chronological age (CA), BA and height of children with MPHD were lower at the start of therapy compared with IGHD. Complete GH deficiency was more common in children with MPHD (62,7%), while partial GH deficiency was more common in children with IGHD (81,7%). Very low values of the coefficient CA/BA (less than 0,55) were significantly more often detected in children with MPHD compared with IGHD. The regional clinical and auxological characteristics of GHD in children in the Odessa region can be considered in further study of population aspects and patterns of growth.

Effect of growth hormone deficiency on brain MRI findings among children with growth restrictions

2015 ◽  
Vol 28 (1-2) ◽  
Author(s):  
Fariba Naderi ◽  
Samira Rajabi Eslami ◽  
Sohrab Afshari Mirak ◽  
Mohammad Khak ◽  
Jalaladin Amiri ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Bone Age ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Endocrine Disorders ◽  
Mri Findings ◽  
Gadolinium Contrast

AbstractGrowth hormone deficiency (GHD) is a major problem among children with short stature. In this study, the role of brain magnetic resonance imaging (MRI) in defining the underlying defects among short children with GHD is evaluated.In a cross-sectional study, data of 158 children were evaluated. Growth hormone (GH) levels were measured using stimulating tests and brain MRI with gadolinium contrast was applied, as well.Some 25.3% of patients had GHD with a mean age of 8.01±3.40 years. MRI results showed 35 as normal, four with pituitary hypoplasia, and one with microadenoma. The MRI results were significantly associated with GH levels and presence of other endocrine disorders. There was a significant association between prenatal disorders and patients’ bone age delay.In patients with severe GHD and patients with multiple pituitary hormone deficiencies, MRI is more likely to be abnormal, and bone age is much delayed in patients with history of prenatal disorders.

scholarly journals GROWTH HORMONE ESTIMATION;

2013 ◽  
Vol 20 (03) ◽  
pp. 385-389
Author(s):  
MUHAMMAD NADEEM HAMEED ◽  
FAUZIA SADIQ ◽  
ASIM MUMTAZ ◽  
Hina Mohiuddin ◽  
Sana Khan ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Hormone Replacement ◽  
Growth Hormone Level ◽  
Hormone Deficiency ◽  
P Value ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hormone Stimulation ◽  
Stimulation Tests

Introduction: Despite the use of growth hormone replacement therapy for decades, our ability to make a definitive diagnosisof growth hormone deficiency in children is limited. Growth hormone stimulation tests have been used to discriminate between Growthhormone deficiency and idiopathic short stature. However all these tests lack reproducibility, accuracy, cost affectivity and safety. Insulinlikegrowth factor-1 is an effector hormone and its serum level may be used as simple, easy to perform diagnostic test for growthhormone deficiency. Objective: To determine the efficacy of IGF-1 as a diagnostic tool in children with growth hormone deficiency. StudyDesign: Prospective cross sectional survey. Place of Study: Departments of Pediatrics and Pathology, Shalamar Medical & DentalCollege, Lahore. Duration of study: 1st July to 31st December, 2011. Material & Methods: We included 40 children of 3.5 – 17 year ageand detailed clinical data was collected. All these children were subjected to stimulation by standardized exercise on treadmill, after takingbasal blood samples for GH and IGF-1. Post stimulation growth hormone was recorded to identify growth hormone deficient children.Results: 17 (42.5%) children had post stimulation growth hormone level <10ng/ml while 23 (57.5%) had values >10ng/ml. Postexercise stimulation GH level showed weak correlation with IGF-1 in either of the two study groups. P value was found >0.05 in deficientas well as sufficient groups, depicting non significance of IGF-1 in relation to post stimulation GH level. Conclusions: IGF-1 is not asuitable surrogate diagnostic marker for growth hormone deficiency. Diagnosis should always be based on combination of auxologicalbiochemical, radiological and genetic considerations, Abbreviations: GHD – Growth Hormone Deficiency, GH – Growth Hormone,GHSTs – Growth Hormone Stimulation Tests, IGF-1 – Insulin-like Growth Factor-1, MPH – Mid Parental Height, BA – Bone Age.

scholarly journals Growth Hormone Deficiency in a Patient with Becker Muscular Dystrophy: A Pediatric Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Valeria Calcaterra ◽  
Annachiara Malvezzi ◽  
Rossana Toglia ◽  
Angela Berardinelli ◽  
Elena Bozzola ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Muscular Dystrophy ◽  
Growth Hormone Deficiency ◽  
Therapeutic Response ◽  
Gh Deficiency ◽  
Bone Age ◽  
Becker Muscular Dystrophy ◽  
Hormone Deficiency ◽  
Pediatric Case ◽  
Greulich And Pyle Method

Objective. To describe a biochemical growth hormone (GH) deficiency and to evaluate therapeutic result in a six-year-old male with Becker muscular dystrophy (BMD).Methods. GH peak was evaluated after response to arginine and insulin. Bone age was evaluated according to Greulich and Pyle method.Results. The GH-supplementary therapy was very effective in terms of growth gain.Conclusion. The possibility of a growth hormone deficiency and treatment with GH in patients with BMD cannot be excluded, especially considering the good therapeutic response.

A novel diagnostic tool for the evaluation of hypothalamic-pituitary region and diagnosis of growth hormone deficiency: pons ratio

2020 ◽  
Vol 33 (6) ◽  
pp. 735-742
Author(s):  
Meliha Demiral ◽  
Mehmet Salih Karaca ◽  
Edip Unal ◽  
Birsen Baysal ◽  
Rıza Taner Baran ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Cost Benefit ◽  
Practical Method ◽  
Hormone Deficiency ◽  
Small Scale ◽  
Pituitary Hormone ◽  
Clinical Value ◽  
Pubertal Status ◽  
Sensitive Tool

AbstractBackgroundsLimitations in the evaluation of the pituitary size and changes according to pubertal status make its validity questionable. Recently, in a small-scale study, pons ratio (PR) has been suggested as a more sensitive tool for diagnosis and etiological evaluation of growth hormone deficiency (GHD). The aim of the study is to evaluate the diagnostic value of PR in the diagnosis of GHD.MethodsWe retrospectively evaluated the pituitary magnetic resonance imaging (MRI) of 133 patients with a diagnosis of GHD. Primary axis (PA) was assigned as a line crossing the mid-sagittal dorsum sella and fourth ventricle. PR was defined as the pons height above the PA divided by total pons height. The PR of patients with GHD was compared to subjects without GHD.ResultsStudy included 133 patients with GHD and 47 controls. In total, 121 (91%) patients had isolated GHD and 12 (9%) patients had multiple pituitary hormone deficiency. The PR of the patient group (mean: 0.32 ± 0.89; range: 0.14–0.63) was significantly higher than controls (mean: 0.26 ± 0.067; range 0.19–0.44) (p: 0.000). The optimal cut-off value of PR for GHD diagnosis was 0.27 (sensitivity 71% specificity 56%). There was a negative correlation between anterior pituitary height (APH)-SDS and PR (p: 0.002; r: −0.27). APH was increased, but PR remained unchanged in pubertal patients (p: 0.089).ConclusionsPR measurement is a noninvasive, practical method with a cost-benefit clinical value. As it is not affected by pubertal status, PR is potentially a more sensitive tool for evaluation of pituitary gland in GHD patients compared to APH.

Transient impairment or delay of urinary trihydroxypregnanone (THS) response to metyrapone in boys with delayed adolescence and in patients with isolated growth hormone deficiency

1982 ◽  
Vol 99 (2) ◽  
pp. 166-173 ◽  
Author(s):  
M. Zachmann ◽  
D. Tassinari ◽  
W. Sorgo ◽  
G. U. Exner ◽  
B. Kempken ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Single Dose ◽  
Growth Hormone Deficiency ◽  
Bone Age ◽  
Urine Samples ◽  
Hormone Deficiency ◽  
Cortisol Response ◽  
Transient Impairment ◽  
Group A ◽  
Group B

Abstract. Twentythree boys with delayed adolescence (age 15.7 ± 2.0, bone age 12.4 ± 2.1 years) were studied. Their cortisol response to insulin was normal. After oral metyrapone (500 mg/m2 by mouth) one to three consecutive 12 h urine samples were collected for analysis of THS. Thirtyseven tests with 37 first, 21 second, and 11 third samples were carried out. The results could be divided into two main groups: 25 tests (group A) were subnormal in the first sample, 12 of them with a very weak (40 ± 8 μg/m2/12 h) and 13 with an insufficient (191 ± 16 μg/m2/12 h) THS response. Values in the second and third sample were higher, indicating a dealyed response. In 12 tests (group B), the results were normal (1016 ± 143 μg/m2/12 h) in the first and lower in the second and third samples. In three patients with repeated tests, there was improvement with increasing bone age. The THS-responses to metyrapone did not correlate with those of growth hormone, gonadotrophins, and TSH to stimuli. It is concluded that the THS-response to a single dose of metyrapone may be temporarily insufficient or delayed in delayed adolescence. We interpret this finding as showing transiently reduced or slow hypothalamic responsiveness.

scholarly journals Síndrome de Klinefelter con deficiencia parcial de hormona de crecimiento.

2015 ◽  
Vol 10 (1) ◽  
pp. 38
Author(s):  
Carlos TORI TORI ◽  
Carlos ROE B.
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Short Stature ◽  
Klinefelter Syndrome ◽  
Bone Age ◽  
Hormone Deficiency ◽  
Klinefelter’S Syndrome ◽  
Klinefelter's Syndrome ◽  
The Third ◽  
Rare Association

We present a case of Klinefelter’s syndrome and short stature due to partial growth hormone deficiency. His height was below the third percentile for age and his bone age lagged behind four years. Cases like this are generally due to the presence of a an isochromosome Xq or to an isolated partial or total deficiency of growth hormone, or to partial or panhypopituitarism. We wish de emphasize the rare association between Klinefelter syndrome and growth hormone deficiency.

Growth hormone replacement for patients with adult onset growth hormone deficiency—what have we learned?

2004 ◽  
Vol 16 (4) ◽  
pp. 1-6
Author(s):  
Monique Piersanti
Keyword(s):  
Growth Hormone ◽  
Gh Deficiency ◽  
Hormone Replacement ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Adult Onset ◽  
Gh Replacement ◽  
Term Benefit

Growth hormone (GH) deficiency is a condition recognized to occur in individuals who have had multiple pituitary hormone deficiencies as a result of pathological processes or neurosurgical interventions. The indications, benefits, and risks of GH replacement therapy will be reviewed with an emphasis on those patients who were adults with the deficiency first emerged. The results of this analysis indicate that, although a measurable improvement can be detected in the patient's quality of life, body composition, and some cardiovascular parameters, the larger questions of long-term benefit and patient selection currently remain unanswered.

Current Dosing of Growth Hormone in Children With Growth Hormone Deficiency: How Physiologic?

PEDIATRICS ◽  
1998 ◽  
Vol 102 (Supplement_3) ◽  
pp. 527-530
Author(s):  
Margaret H. MacGillivray ◽  
Sandra L. Blethen ◽  
John G. Buchlis ◽  
Richard R. Clopper ◽  
David E. Sandberg ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Adverse Events ◽  
Growth Hormone Deficiency ◽  
Growth Velocity ◽  
Bone Age ◽  
Early Initiation ◽  
Hormone Deficiency ◽  
Treatment Result ◽  
Recombinant Growth Hormone ◽  
Pituitary Growth Hormone

The current doses of recombinant growth hormone (rGH) are two to three times those used in the pituitary growth hormone era. These rGH doses (0.025 to 0.043 mg/kg/d) are similar to or moderately greater than the physiologic requirements. Growth velocity and height gains have been shown to be greater with 0.05 mg/kg/d of rGH than with 0.025 mg/kg/d. Larger doses of GH and early initiation of treatment result in greater heights at the onset of puberty and greater adult heights. Earlier onset of puberty and more rapid maturation, as indicated by bone age, were not observed in children who were given 0.18 to 0.3 mg/kg/wk of rGH. The frequency of adverse events is very low, but diligent surveillance of all children who are treated with rGH is essential.

A Review of Growth Hormone Stimulation Tests in Children

PEDIATRICS ◽  
1974 ◽  
Vol 53 (6) ◽  
pp. 929-937
Author(s):  
S. Douglas Frasier
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Hormone Deficiency ◽  
Current Evidence ◽  
Oral Glucose ◽  
Normal Children ◽  
Small Magnitude ◽  
Arginine Infusion ◽  
Sequential Administration ◽  
Stimulation Tests

No suggested screening test meets all of the criteria set for such a procedure. The minimum incidence of a positive response in normal children detected in a single blood sample after diethylstilbestrol, sleep or exercise is approximately 70%. This is higher than that observed when a single sample is obtained following oral glucose. While both sleep and exercise are physiologic stimuli, the former may be quite inconvenient unless an outpatient facility staffed with appropriate personnel is available. An exercise test employed in the office may well be the best screening procedure for the practicing physician. The optimal criteria for a definitive test of growth hormone function are also not met by any single stimulus. Insulin-induced hypoglycemia, arginine infusion, intramuscular glucagon and oral 1-DOPA are all useful procedures. None alone discriminate completely between the normal and the growth hormone-deficient child. Despite potential hazards, insulin-induced hypoglycemia remains the standard against which other stimuli are judged. Arginine and 1-DOPA appear to be equally effective. The literature contains insufficient data to allow adequate evaluation of intramuscular glucagon alone, and the results of combined propranolol-glucagon stimulation, while promising, require confirmation. Because of an inconstant and/or small magnitude of response leading to results which are difficult to interpret, the use of glucose, pyrogen, vasopressin and ACTH are not adequate tests of growth hormone function. Bovril® is a satisfactory stimulus for those children who will take it. Those factors which modify the growth hormone response must be considered in evaluating the results of stimulation tests. Blunted responses should be interpreted with extreme caution in the obese child. A fasting growth hormone concentration ≥ 7 ng/ml is presumptive evidence of intact growth hormone function regardless of the subsequent response to stimulation. It is essential that patients be euthyroid in order to interpret the results of growth hormone function tests. Physiologic glucocorticoid replacement therapy should not confuse the interpretation of results. Whether or not pretreatment with sex steroids is worthwhile in the routine evaluation of children for suspected growth hormone deficiency is an open question. Although it is agreed that the definitive diagnosis of growth hormone deficiency depends on the demonstration of failure to respond to two stimuli, which two are most satisfactory is not settled. The sequential administration of arginine and insulin on the same day appears to limit significantly the incidence of false-positive laboratory diagnoses of growth hormone deficiency. The significance of intermediate values in response to stimulation remains unclear. Caution should be exercised in assigning a child to the category of partial growth hormone deficiency. This question must be answered ultimately by the response to HGH therapy in the individual patient. Finally, several points should be kept in mind. All of the tests described depend on the detection and quantitation of immunologically active HGH and biological activity is not necessarily associated with the material(s) being measured. Since many of the stimuli used in the evaluation of growth hormone function are clearly pharmacologic, the physiological significance of the response to such stimuli must be interpreted with caution. The best current evidence suggests that all of the stimuli described act through an intact hypothalamus and pituitary. Differentiation between hypothalamic and pituitary sites of defective growth hormone function awaits the availability of growth hormone-releasing factor(s).

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