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Approach to the Patient: Case Studies in Pediatric Growth Hormone Deficiency and Their Management
Rohan K Henry1, Bradley S Miller2
1Section of Endocrinology, Department of Pediatrics, Nationwide Children's Hospital/The Ohio State University College of Medicine, Columbus, OH 43205, USA.
The Journal of Clinical Endocrinology and Metabolism
|May 29, 2023
Summary
Pediatric growth hormone deficiency (GHD) management is practical and pragmatic. Timely interventions improve growth and metabolic outcomes in children with GHD.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Axis Disorders
Background:
- Growth hormone/Insulin-like growth factor-I (GH/IGF-I) axis perturbations are common in pediatric endocrinology referrals.
- Understanding diverse etiologies and presentations of pediatric GHD is crucial.
Approach:
- Presents a practical, case-based approach to managing pediatric growth hormone deficiency (GHD).
- Utilizes four distinct case vignettes illustrating congenital GHD, failure to thrive, growth deceleration, and metabolic complications.
- Reviews diagnostic considerations and management strategies based on current clinical guidelines, incorporating new therapeutic and diagnostic modalities.
Key Points:
- Case 1: Congenital GHD.
- Case 2: Childhood GHD presenting as failure to thrive.
- Case 3: Childhood GHD presenting as growth deceleration in adolescence.
- Case 4: Childhood-onset GHD with adolescent metabolic complications.
Conclusions:
- Pediatric GHD exhibits varied etiology and clinical manifestations.
- Prompt management of GHD can significantly improve growth trajectories.
- Effective GHD treatment can mitigate or prevent adverse metabolic consequences.
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