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HELENA KEANE, UK
Helena has GHD
Growth Hormone Deficiency (GHD) in Children

If your child has been diagnosed with growth hormone deficiency (GHD), their body is unable to produce enough growth hormone. The key sign of this is a much shorter height than expected for their age. Most children with GHD are otherwise healthy, with no related medical conditions. Before diagnosing GHD, you child’s doctor will have undertaken a wide range of tests and examinations to rule out other reasons for poor growth.

There are many possible causes of GHD. It sometimes results from a birth defect and appears during infancy – or it may occur after birth, appearing later in childhood.

Growth Hormone Deficiency in Adults (AGHD)

Growth hormone is important for adults to maintain a healthy body and normal brain function. However, your ability to produce growth hormone can be affected by a number of factors, including:

  • Having growth hormone deficiency as a child
  • Having a tumour in the area of the brain near the pituitary gland – or undergoing surgery or radiotherapy to treat a tumour in this area
  • Having an accident in which your brain was damaged.

In these cases, you may be lacking in growth hormone. This is called adult growth hormone deficiency, or AGHD. Growth hormone deficiency in children and adults can be corrected with hormone injections.

WILL, UK
Will is a GHT patient
Importance of the pituitary gland

Hormones deliver messages to stimulate specific cells or tissues. Growth hormone is produced in the pituitary gland. It stimulates the secretion of insulin-like growth factor 1. Both of these hormones are involved in growth during childhood and adult life. Adults with GHD are unable to produce enough growth hormone. This leads to a variety of symptoms from a decrease in muscle strength to an increase in body fat.

Lifestyle

Adults with GHD are more at risk of heart disease because they have abnormal levels of good and bad cholesterol. To control this, they must make sure to eat a balanced diet and participate in exercise. This should prevent them from becoming overweight. Adults must also have a calcium rich diet with sufficient levels of vitamin D. This is because GHD patients have a higher risk of osteoporosis. This causes brittle bones and can increase the risk of fractures from a minor injury.

GHD diagnosis

GHD is diagnosed using an insulin tolerance test. This should not be performed if a patient has epilepsy or heart disease. However, if the patient does not have these conditions, the test can go ahead. It is carried out in a specialist unit as an outpatient or day case. It will take two to four hours and patients will not be allowed to eat before the procedure. The procedure involves an injection to lower their blood sugar and then blood samples are taken at regular intervals. Normally the body will release growth hormone in response to a low blood glucose level. However if an adult has GHD, they will be unable to produce an adequate level of growth hormone. A patient may find this process uncomfortable but this will not last long. However if there are adverse side effects, the test can be stopped by giving glucose. This will not invalidate the test.

Chronic Renal Disease (CRD) in Children

Chronic Renal Disease (CRD) is a long-term condition characterised by a gradual loss of kidney function. Around 1 in 3 children with CRD have problems with their growth, resulting in a shorter height than other children of their age.

Damaged kidneys can slow a child’s growth by:

  • Causing hormonal and mineral imbalances
  • Decreasing appetite, leading to poor nutrition
  • Reducing the number of oxygen-carrying blood cells
  • Disrupting the body’s fluid balance
  • Preventing the body from correctly using growth hormone
Small for Gestational Age (SGA)

Gestational age is the number of weeks that a foetus has been growing inside the womb. Most babies are born after 38 to 42 weeks of gestation. As soon as a baby is delivered, the child’s weight and length are recorded. These measurements are then compared with those expected for their gestational age. If you were told that your baby was Small for Gestational Age (SGA), it means that your child was smaller than 97% of all other babies born after spending the same time in the womb.

Most of the time, doctors don’t know why a child was born SGA. When a cause can be determined, it is usually associated with multiple birth (e.g. twins or triplets); a genetic defect; maternal health issues; or problems with the placenta. Children born SGA may have a normal amount of growth hormone, or they may have less growth hormone than the average child.

Most SGA babies have catch-up growth, making them no smaller than children of the same age after 2–4 years. However, if this doesn’t happen, the child may need extra growth hormone to give them a helping hand.

ANAIS
Anais was born small for gestational age
Turner Syndrome (TS)

Turner syndrome (TS) is a genetic disorder that only affects females. It is caused by a missing or structurally altered X chromosome. While TS is associated with the following traits and conditions, some girls and women only have a few of these:

  • Short stature
  • Heart defects
  • Ovarian failure (inability to progress through puberty as normal)
  • Short neck with a webbed appearance
  • Low hairline at the back of the neck
  • Differently shaped, low-set ears
  • High-arched palate
  • Small jaw
  • Broad chest
  • Larger number of moles on the skin
  • Drooping eyelids
  • Puffy hands and feet (lymphoedema)
HELENA KEANE, UK
Helena has GHD

As people with TS have a tendency to gain excess weight, this should be carefully monitored along with other health parameters, such as blood pressure, blood glucose and hormone levels. It is also important to encourage exercise and healthy food choices from an early age. Short stature affects nearly everyone with TS. The average adult height of women with the condition is 4’ 8” without treatment.

Date of preparation: September 2020
UK20GH00083
This page is intended for members of the UK public