II. Epidemiology

  1. Incidence: 1 in 3,000 to 9,000

III. Causes

  1. Congenital
  2. Acquired
    1. Head Trauma
    2. CNS Infection
    3. Birth Trauma
    4. Cranial irradiation

IV. Signs: Congenital GH Deficiency (newborns)

  1. Normal size at birth
    1. Subsequently falls off height growth curve
    2. Weight for age is preserved
  2. Episodic Hypoglycemia
  3. Prolonged Neonatal Jaundice
  4. Microphallus
  5. Midline craniofacial abnormalities

V. Signs: Adults

  1. Fatigue
  2. Decreased Muscle mass and strength
  3. Increased visceral fat
  4. Premature atherosclerosis

VI. Imaging

  1. Bone Age Film
    1. Delayed Bone Age
  2. Brain MRI

VII. Labs (in Consultation with pediatric endocrinology)

  1. Screening
    1. Insulinlike Growth Factor 1 (IGF-1)
    2. Insulinlike Growth Factor binding Protein 3
  2. Diagnosis
    1. Negative Growth Hormone provocation test
    2. Pituitary Function Tests

VIII. Management

  1. Pediatric Endocrinology referral
  2. Recombinant Growth Hormone injections daily

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