Growth hormone deficiency (GHD) is a rare but treatable cause of growth failure in children.
May be isolated or combined with other anterior and/or posterior pituitary hormone deficiencies. The cause may be congenital or acquired.
Diagnosis is based on a combination of biochemistry, neuroradiology, and clinical phenotype.
Treatment in the form of recombinant human GH (rhGH) is safe and highly efficacious. Rapid diagnosis with early treatment results in attainment of a normal final height in most individuals.
Associated pituitary hormone deficiencies require treatment with hormone replacement.
Endocrine reassessment should be undertaken after completion of growth and puberty, because some patients will require long-term GH therapy.
Growth hormone deficiency (GHD), defined as suboptimal GH secretion, includes a group of different aetiological disorders. It may be isolated or combined with other anterior and/or posterior pituitary hormone deficiencies. Combined pituitary hormone deficiency (CPHD) is defined as a deficiency in 2 or more pituitary hormones. GHD may be congenital or acquired, sporadic or familial.
History and exam
Ameeta Mehta, MBBS, DCH, DNBE, MSc, MRCP, MD
AM is an author of several references cited in this topic.
Mehul T. Dattani, MBBS, DCH, FRCPCH, FRCP, MD
Professor of Paediatric Endocrinology
Consultant in Paediatric and Adolescent Endocrinology
Great Ormond Street Hospital for Children and
University College London Hospitals
MTD has received lecture fees from Novo Nordisk, Pfizer, and Ipsen; consultancy fees from Novo Nordisk, Pfizer, Ipsen, and Sandoz; and is a member of a Novo Nordisk advisory board. Novo Nordisk, Pfizer, Ferring, Ipsen, Lilly, Merck, and Serono have made financial contributions to MTD's departmental teaching programme. MTD declares that none of these activities are related to this topic. MTD is an author of a number of references cited in this topic.
Dr Ameeta Mehta and Dr Mehul T. Dattani would like to gratefully acknowledge Dr Kyriaki S. Alatzoglou, a previous contributor to this topic. KSA is an author of a number of references cited in this monograph.
Martin Savage, MA, MD, FRCP, MRCPCH
Professor of Paediatric Endocrinology (Emeritus)
Department of Endocrinology
William Harvey Research Institute
St Bartholomew's and the Royal London School of Medicine and Dentistry
John Vane Science Centre
MS has received honoraria and consultancy payments from Ipsen, Pfizer, Novo Nordisk, and Merck Serono.
Paul Saenger, MD, MACE
Professor of Pediatrics
Department of Pediatrics (Endocrinology)
Montefiore Medical Center
Albert Einstein College of Medicine
PS declares that he has no competing interests.
American Association of Clinical Endocrinologists medical guidelines for clinical practice for growth hormone use in growth hormone-deficient adults and transition patients - 2009 update external link opens in a new windowMore guidelines
Use of this content is subject to our disclaimer