Karen Joy S.

Pagayunan
MD3Y1-4

September 27, 2016

A CASE STUDY ABOUT ACQUIRED GROWTH HORMONE DEFICIENCY

I.

HISTORY
JM was a 3 year-old normal kid born and raised in a healthy family when he
accidentally bumped his head at the playground. He is 18 now but he is shorter than his
peers, has younger and rounder face, and has a voice not as deep compared to boys at
his age its as if his puberty got delayed. As early as 15, he was diagnosed with
diabetes and heart disease. His parents got him checked by their family physician,
monitoring his height and weight on a regular basis.

II.

SIGNS AND SYMPTOMS

Physiologic Symptoms
Short stature
Younger and rounder face compared to peers
Chubby
Always feels tired
Lacks stamina
Sensitive to hot and cold
Psychologic Symptoms
Depression
Lack of concentration
Poor memory
Bouts of anxiety or emotional distress

III.

TEST CONDUCTED
Testing can determine if the pituitary condition was present at birth or brought on by an
injury or tumor.
1. Physical Examination
The doctor will look for signs of GHD if the patient is not meeting his height and
weight milestones. The doctor asks about the patients growth rate as he/she approached
puberty, as well as his/her other sibling/s growth rate/s. If he suspects GHD, a number of
tests can confirm the diagnosis.
2. Blood test
This can measure growth hormone levels in the body. However, an individuals
levels of growth hormone fluctuate widely in a diurnal variation. A blood test with a lowerthan-normal result however, is not enough evidence to make a diagnosis.
3. X-ray
Growth plates are the developing tissue at each end of an individuals arm and
leg bones. Growth plates fuse together when a person has finished developing. X-rays of
the patients hand can indicate his/her level of bone growth.

4. Kidney and Thyroid function tests

Kidney and thyroid function tests can determine how the body is producing and
using hormones.
5. MRI imaging scan
If the doctor suspects a tumor or other damage to the pituitary gland, an MRI
imaging scan can provide a detailed look inside the brain. Growth hormone levels will
often be screened in adults who have a history of pituitary disorders, have a brain injury,
or need brain surgery.
IV.

TREATMENT
Since the mid-1980s, synthetic growth hormones have been used with great success to
treat children and adults. Before synthetic growth hormones, natural growth hormones from
cadavers were used for treatment.
Growth hormone is given by injection, typically into the bodys fatty tissues, such as the
back of the arms, thighs, or buttocks. Its most effective as a daily treatment.

Side effects are generally minor, but may include:

redness at the injection site
headaches
hip pain
curving of the spine (scoliosis)

In rare cases, long-term growth hormone injections may contribute to the development of
diabetes, especially in people with a family history of that disease.
For long term treatment, children with congenital GHD are often treated with growth hormone
until they reach puberty. Often, children who have too little growth hormone in their youth will
naturally begin to produce enough as they enter adulthood. However, some remain in treatment
for their entire lives. The doctor can determine if the patient needs ongoing injections by
monitoring hormone levels in his/her blood.
V.

CONCLUSION
A growth hormone deficiency (GHD) occurs when the pituitary gland doesnt produce
enough growth hormone. It more commonly affects children than adults. The pituitary gland is a
small gland about the size of a pea. Its located at the base of the skull and secretes eight
hormones. Some of these hormones control thyroid activity and body temperature. GHD occurs in
roughly 1 in 7,000 births. The condition is also a symptom of several genetic diseases, including
Turner syndrome and Prader-Willi syndrome. Serious head injuries, infections, and radiation
treatments can also cause GHD. This is called acquired growth hormone deficiency (AGHD).

VI.

COMMENTS AND SUGGESTIONS

Children who are diagnosed early often recover very well. If left untreated, the condition
can result in shorter-than-average height and delayed puberty, such as that of JMs.