Growth Hormone Deficiency

Aka: Growth Hormone Deficiency, GH Deficiency, Somatotropin Deficiency

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II. Epidemiology

  1. Incidence: 1 in 3,000 to 9,000 children with Short Stature

III. Causes

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

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 (e.g. Cleft Lip)

V. Signs: Acquired

  1. Children
    1. Normal initial growth until onset of GH Deficiency
    2. Progressive Growth Delay (depending on severity)
  2. Adults
    1. Fatigue
    2. Decreased Muscle mass and strength
    3. Increased visceral fat
    4. Premature atherosclerosis

VI. Imaging

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

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

IX. References

  1. (2000) J Clin Endocrinol Metab 92(3): 804-10 [PubMed]
  2. Barstow (2015) Am Fam Physician 92(1): 43-50 [PubMed]
  3. Caro (2025) Am Fam Physician 111(6): 532-42 [PubMed]

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