Proper use of growth hormone
Article Abstract:
Growth hormone, or somatotropin, is released from the anterior pituitary and is important in regulating growth. This hormone has been used to increase the rate of growth in three classes of patients: (1) those who are growth hormone deficient, where there is biochemical and clinical evidence of a deficiency in growth hormone; (2) those who are growth hormone responsive but not necessarily deficient, where the hormone can increase height; and (3) an experimental group, in which growth hormone treatment may be beneficial. Growth hormone deficient patients have damage to the hypothalamus or pituitary, which may or may not be detected by imaging techniques. They tend to be short, grow slowly, and have little or no growth hormone response to testing. Growth hormone responsive patients secrete less than normal levels of growth hormone, usually because of damage to the hypothalamus. These patients are short, slowly growing, and responsive to growth hormone treatment despite normal growth hormone biochemistry. An increase in the rate of growth by two centimeters per year over six months is good evidence for continuing growth hormone treatment. Patients with Turner's syndrome, a birth-related glandular disorder, are growth hormone responsive. The disease is caused by the failure of the ovaries to respond to pituitary hormones, and patients are short, and fail to mature sexually or, if female, to menstruate. Growth hormone treatment has also been used to treat children with growth delay during pregnancy, and children with uremia, the accumulation of nitrogen-containing wastes due to impaired kidney function. Growth hormone is very expensive and results of treatment can only be fully assessed in adulthood. Although increased doses of growth hormone are associated with greater rates of growth, an appropriate physiological dose should be used. Some possible risks associated with growth hormone treatment include the development of leukemia, diabetes, or gigantism, excessive development of the body or part. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1990
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Growth failure secondary to moyamoya syndrome
Article Abstract:
Growth failure can occur when there is a deficiency of growth hormone produced by the pituitary gland. A seven-year-old boy was evaluated by an endocrinologist for short stature, obesity, small penis, and headaches. The child had a history of developmental delays, originally thought to be caused by a lack of stimulation by his parents. An biochemical examination did not reveal any muscle disease that could explain lower limb weakness. At seven years of age the boy's bone structure resembled a three- to four-year-old child's. Tests that measure pituitary function revealed a decreased production in growth hormone indicative of hypopituitarism. Growth hormone therapy was initiated, which caused an increase in growth of 9.8 centimeters in one year. When the child was 7.9 years of age he experienced a generalized epileptic seizure. At 8.4 years of age, the headaches worsened and he was admitted to the hospital with blurred vision, uncoordinated movements, and increased seizure activity. Tumor-like tissue was located in the brain, which appeared to be spreading into the cerebrospinal fluid space (space surrounding the brain and spinal cord). An examination of the tissue during exploratory surgery found a mass network of blood vessels, arteries, and veins. An angiography of the brain was performed and an abnormal blood vessel pattern at the base of the brain was noted, which was caused by the narrowing or blockage of the internal carotid artery feeding the brain. This condition, termed Moyamoya syndrome, causes collateral blood vessels to form. The mass network of collateral blood vessels is thought to have caused the brain lesion. The child resumed growth hormone, thyroxine (thyroid hormone), and carbamazepine (anti-seizure agent) treatments. The parents were urged to have the child avoid extreme physical activity and contact sports, since injury may cause hemorrhage of fragile blood vessels. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1990
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A new syndrome of congenital hypoparathyroidism, severe growth failure, and dysmorphic features
Article Abstract:
Parathyroid hormone is one of the chief regulators of calcium metabolism, and hypoparathyroidism (decrease in parathyroid hormone) is related to a range of syndromes which feature hypocalcemia (low blood calcium levels) and hyperphosphatemia (high blood phosphate levels). Hypoparathyroidism frequently occurs in newborns in association with prematurity, maternal diabetes, and other risk factors, and is rarely a congenital (present at birth), permanent condition. The cases of 12 patients with an unusual syndrome of congenital hypoparathyroidism are reviewed in this article. Males and females were equally affected. Intrauterine growth retardation occurred in all but one patient, and five were born prematurely. For 10 of the patients, their parents were first cousins. The disorder was usually detected due to convulsions or to muscle tetany (prolonged contraction) associated with low calcium levels. Growth failure and mental retardation were found in all patients, and many had feeding disorders, vomiting, and diarrhea. All patients had dysmorphic (of abnormal structure) features, usually small head size, deep-set eyes, and lip, nose, and ear abnormalities. Besides hypocalcemia and hyperphosphatemia, patients had low blood magnesium levels. Patients were treated with vitamin D and calcium supplements, and some were given magnesium, but growth failure and mental delay persisted in spite of normalization of blood parameters. Two patients died of pneumonia under the age of one year and two others died of unknown causes, at nine months and two years. This syndrome is distinguished from DiGeorge's syndrome, another disorder featuring congenital hypoparathyroidism, by normal immune function, lack of cardiac anomalies, and distinct facial characteristics. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1991
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