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Growth hormone deficiency presenting under age 2 years
Insights
Early diagnosis of growth hormone deficiency (GHD) is crucial. GHD should be suspected in infants with persistent hypoglycemia and in boys with failure to thrive and microgenitalia.
Area of Science:
- Pediatrics
- Endocrinology
- Genetics
Background:
- Growth hormone deficiency (GHD) can manifest in early infancy.
- Infants with GHD may present with non-specific symptoms, delaying diagnosis.
Purpose of the Study:
- To identify early clinical signs of GHD in a national cohort.
- To improve the diagnostic approach for GHD in young children.
Main Methods:
- Retrospective analysis of a national cohort of 1600 patients with GHD.
- Categorization of presentation age and associated symptoms.
Main Results:
- 29 patients (1.8%) presented before age 2 years.
- 16 presented before 6 months with hypoglycemia (11), failure to thrive (4), or obesity (1).
- 13 presented between 6 months and 2 years with failure to thrive (12) or hypoglycemia (1).
- Hypoglycemia was often persistent and linked to multiple pituitary hormone deficiencies.
- Microgenitalia was common in affected boys.
Conclusions:
- GHD should be considered in infants with refractory hypoglycemia.
- Consider GHD in boys with failure to thrive and microgenitalia.
- Early recognition of these signs can lead to timely diagnosis and treatment.
Abstract:
Twenty nine (1.8%) of a national cohort of 1600 patients with growth hormone deficiency presented before the age of 2 years. Sixteen of the 29 presented before 6 months of age--11 with symptomatic hypoglycaemia, four with failure to thrive, and one with obesity. Hypoglycaemia was persistent and difficult to control until growth hormone treatment was started. Ten of the 11 hypoglycaemic patients had multiple pituitary hormone deficiencies compared with two of the remaining five. Thirteen children presented between 6 months and 2 years of age; 12 had failure to thrive and one had spontaneous hypoglycaemia. Twelve of the 29 were boys and all but one of these had microgenitalia . Growth hormone deficiency should be considered in the differential diagnosis of infants presenting with refractory hypoglycaemia and in boys with failure to thrive and microgenitalia .