Growth Hormone Deficiency: Diagnosis and Therapy in Children

Short stature has been defined as a height below the 2 standard deviation for age, sex
and ethnicity. Growth hormone deficiency (GHD) represents a condition characterized
by reduced GH secretion, isolated or associated with other pituitary hormone
deficiencies. In a child with short stature and growth deceleration, after the exclusion
of other causes of growth failure, the diagnosis of GHD has to be confirmed by
measurement of GH secretion after at least two stimulation tests. Patients with GHD
should be treated with rhGH as soon as possible, to obtain normalization of growth and
normal final height. The catch-up growth in response to rhGH therapy is maximal
during the first years and could be affected by many variables, such as birth-weight, age
and height at start of treatment and of puberty, and duration of treatment. Overall, rhGH
is believed to be safe and significant side-effects in children are very rare, including
benign intracranial hypertension, hyperglycaemia, arthralgia and myalgia. Patients
with childhood onset GHD are usually retested in late adolescence to confirm the GHD
persistence and to continue of GH therapy. In conclusion, the present chapter provides
useful and updated information about the diagnosis, treatment and follow-up of
children with GHD.