Short stature hormone, deficiency

Genotropin Somatropin Pharmacia Upjohn Short stature in children due to growth hormone deficiency... 

The most controversial approved use of GH is for children with idiopathic short stature, also known as non-growth-hormone-deficient short stature. This is a heterogeneous population that is defined clinically by a height that is 2.25 standard deviations or more below the national norm for children of the same age. Eligible children also have growth... 

Established indications for somatropin (growth hormone) include growth hormone deficiency in children, Turner s syndrome, Noonan s syndrome, and renal insufficiency in children. Other well-studied indications include idiopathic short stature, adult growth hormone deficiency, osteoporosis, and catabolic states associated with acute and chronic illness and injury. Body composition, respiratory muscle function, physical strength, and height improved in a 12-month trial of somatropin in 54 children with Prader-Willi syndrome (1). 

Growth hormone deficiency leads to inadequate somatomedin production and short stature. Rarely, short stature may be caused by IGF-I deficiency despite high growth hormone levels (Laron dwarfism) or a lack of a pubertal surge of IGF-I (pygmies). 

Indications Growth failure, growth hormone deficiency, short stature (in Turner s syndrome), muscle wasting (in HIV positive patients)... 

Growth hormone deficiency in children can be treated by administration of recombinant GH or, in some cases, growth hormone-releasing hormone. Potential targets for recombinant GH that are undergoing clinical investigation include children with idiopathic short stature, persons with wasting syndrome associated with human immunodeficiency virus infection, critically ill patients, and elderly individuals. 

Destruction of the pituitary gland may result in secondary hypothyroidism, hypogonadism, adrenal insufficiency, growth hormone deficiency, and hypoprolactinemia. The formation of certain types of pituitary tumors may result in pituitary hormone excess. Pituitary tumors may also physically compress the pituitary and prevent the release of the trophic hypothalamic factors that regulate pituitary hormones. In this chapter, the pathophysiology and role of pharmacotherapy in the treatment of acromegaly, short stature, hyperprolactinemia, and panhypopituitarism will be discussed. 

Children with growth hormone (GH)-deficient or GH-insufficient short stature may also present with central obesity, prominence of the forehead, and immaturity of the face. 

Hindmarsh PC, BrookCGD. Short stature and growth hormone deficiency. Clin Endocrinol 1995 43 133-142. 

INDICATIONS FOR GROWTH HORMONE TREATMENT GH deficiency in children is a weU-accepted cause of short stature replacement therapy is used to treat children with severe GH deficiency. GH therapy has been extended to children with other conditions associated with short stature despite adequate GH production, including Turner s syndrome, Prader-Willi syndrome (in the absence of morbid obesity or obstructive sleep apnea), chronic renal insufficiency, children bom small for gestational age, and children with idiopathic short stature (i.e., more than 2.25 standard deviations below mean height for age and sex but normal laboratory indices of GH levels). 

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