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Profile of growth hormone deficiency in Bombay
M Desai1, P Colaco, K P Sanghavi
1Pediatric Endocrine Division, Bai Jerbai Wadia Hospital for Children, Bombay.
Insights
Growth hormone deficiency (GHD) affects 23% of children with short stature. This study highlights a high incidence of familial GHD and growth hormone resistance, emphasizing the need for early diagnosis and intervention.
Area of Science:
- Pediatric Endocrinology
- Growth Disorders
Background:
- Short stature is a common concern in pediatric endocrinology.
- Growth hormone deficiency (GHD) is a significant cause of impaired growth in children.
Purpose of the Study:
- To evaluate the prevalence and characteristics of growth hormone deficiency in children presenting with short stature.
- To identify etiological factors, including idiopathic GHD, organic causes, and GH resistance.
Main Methods:
- Retrospective analysis of 430 children referred for short stature evaluation.
- Diagnosis of GHD confirmed by a minimum of two stimulation tests.
- Classification of GHD into idiopathic, organic, and GH resistance categories.
Main Results:
- 100 children (23%) were diagnosed with GHD, with a male predominance (1.94:1).
- Idiopathic GHD (IGHD) accounted for 75 cases, with 31% being familial.
- A notable 11% of cases presented with GH resistance, showing significant height retardation.
Conclusions:
- Familial cases and GH resistance represent significant proportions of GHD in children with short stature.
- Early recognition of growth failure is crucial, even if symptoms appear earlier than the typical presentation age.
- Multitropic pituitary hormone deficiency (MPHD) was observed in both IGHD and organic GHD groups.
Abstract:
Of the 430 children referred for the evaluation of short stature 100 (23%) were confirmed to have growth hormone deficiency. The male to female ratio was 1.94:1. Less than 10% belonged to the lower socio-economic group. Most of the cases (73%) presented between the ages of 6-15 years though growth failure was usually recognised earlier. Minimum of two stimulation tests were performed in each case. Seventy five GH deficient children had idiopathic GHD (IGHD) and 31% of these were familial. Fourteen had organic causes and 11 had GH resistance. Of 75 with IGHD, 18 had abnormal deliveries, breech or birth asphyxia. Multitropic pituitary hormone deficiency (MPHD) was found in 9/75 cases of idiopathic GHD and in three of the organic group. The height age was much more retarded than chronologic age in the GH resistant group (p less than 0.05) and the HA/BA ratio was also lowest in this group (p less than 0.001). Growth velocity was less than 4 cm/year in all the GHD children but was lowest in those with MPHD. The interesting feature of this study is the marked predominance of the familial cases 31% and a high incidence of growth hormone resistant cases (11%).