Growth hormone deficiency natural history, complications and prognosis: Difference between revisions
No edit summary |
|||
| Line 10: | Line 10: | ||
===Natural History=== | ===Natural History=== | ||
*The symptoms of | *The symptoms of growth hormone deficiency usually develop in the first days of life and start with symptoms such as perinatal asphyxia, neonatal hypoglycemia, reduced birth length, and prolonged jaundice especially if associated with ACTH deficiency. If left untreated, patients with growth hormone deficiency may progress to develop delayed postnatal growth, and growth failure can occur during the first months of life [28-31], delayed bone age, delayed puberty, infantile fat distribution, and infantile voice. | ||
===Complications=== | ===Complications=== | ||
* | *Patients less healthy and less energetic than normal people of the same age. [14-16] Fractures of the lumbar spine is somewhat lower in patients with adult-onset GH deficiency | ||
**[ | * The degree of osteopenia appears to correlate directly with the degree of GH deficiency<sup>[[Growth hormone deficiency history and symptoms#cite note-pmid10372687-5|<nowiki>5]</nowiki>]]</sup> | ||
**[ | |||
**[ | * '''Cardiovascular complications''' | ||
** Dyslipidemia<sup>[[Growth hormone deficiency history and symptoms#cite note-pmid10566630-7|[7]]]</sup> | |||
** Increased inflammatory markers<sup>[[Growth hormone deficiency history and symptoms#cite note-pmid11739438-8|[8]]]</sup> | |||
** Increase in biochemical markers of endothelial dysfunction<sup>[[Growth hormone deficiency history and symptoms#cite note-pmid11549653-9|[9]]]</sup> | |||
** High coronary calcium scores (a marker of subclinical atherosclerosis)<sup>[[Growth hormone deficiency history and symptoms#cite note-pmid20511726-10|[10]]]</sup> | |||
* Mortality | |||
Patients with hypopituitarism had a mortality rate twice that of age- and sex-matched normal subjects, a difference due to an increased number of cardiovascular events [23] | |||
==Prognosis== | ==Prognosis== | ||
Revision as of 15:08, 14 August 2017
|
Growth hormone deficiency Microchapters |
|
Differentiating Growth hormone deficiency from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Growth hormone deficiency natural history, complications and prognosis On the Web |
|
American Roentgen Ray Society Images of Growth hormone deficiency natural history, complications and prognosis |
|
FDA on Growth hormone deficiency natural history, complications and prognosis |
|
CDC on Growth hormone deficiency natural history, complications and prognosis |
|
Growth hormone deficiency natural history, complications and prognosis in the news |
|
Blogs on Growth hormone deficiency natural history, complications and prognosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
- If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
- Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
- Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Natural History, Complications, and Prognosis
Natural History
- The symptoms of growth hormone deficiency usually develop in the first days of life and start with symptoms such as perinatal asphyxia, neonatal hypoglycemia, reduced birth length, and prolonged jaundice especially if associated with ACTH deficiency. If left untreated, patients with growth hormone deficiency may progress to develop delayed postnatal growth, and growth failure can occur during the first months of life [28-31], delayed bone age, delayed puberty, infantile fat distribution, and infantile voice.
Complications
- Patients less healthy and less energetic than normal people of the same age. [14-16] Fractures of the lumbar spine is somewhat lower in patients with adult-onset GH deficiency
- The degree of osteopenia appears to correlate directly with the degree of GH deficiency5]
- Cardiovascular complications
- Mortality
Patients with hypopituitarism had a mortality rate twice that of age- and sex-matched normal subjects, a difference due to an increased number of cardiovascular events [23]
Prognosis
- Since recombinant DNA–derived growth hormone became available, most children with growth hormone deficiency reach normal adult stature.
- Initiate growth hormone therapy as early as possible and continue therapy through adolescence to ensure the best chance of achieving height potential.
Childhood
- In the first year of treatment, the rate of growth may increase from half as fast as other children are growing to twice as fast.
- Growth typically slows in subsequent years, but usually remains above normal so that over several years a child who had fallen far behind in his height may grow into the normal height range. Excess adipose tissue may be reduced.
Adulthood
GH treatment can confer a number of measurable benefits to severely GH-deficient adults, such as enhanced energy and strength, and improved bone density. Muscle mass may increase at the expense of adipose tissue. Although adults with hypopituitarism have been shown to have a reduced life expectancy, and a cardiovascular mortality rate more than double controls,[4] treatment has not been shown to improve mortality, although blood lipid levels do improve. Similarly, although measurements of bone density improve with treatment, rates of fractures have not been shown to improve.[4]