The growth and development of an individual is regulated by the pituitary gland located at the base of the brain. The pituitary gland is responsible for the release of the growth hormone (GH) regulated by the hypothalamus, a small lobe located just above the pituitary gland. GH in children is essential for their healthy height development and in adults it is associated with the bone health, muscle strength and fat distribution of the body. Growth Hormone Deficiency(GHD) is the common condition associated with the growth disorder resulting from the low production of GH. The other rare condition is called acromegaly in adults resulting in excess production of growth hormones causing gigantism.
Growth Hormone Deficiency (GHD)
This develops due to insufficient growth hormone released by the pituitary gland resulting in dwarfism. This disorder is also known as pituitary dwarfism. The healthy children tend to grow up to 5cm a year, but the children with congenital GHD may illustrate delayed growth after two or three years of age, or may be evident soon after the birth. Growth hormone deficiency can be present at birth (congenital growth hormone deficiency) or can develop in childhood and adults as an acquired deficiency. Some of the signs of GHD in children are short stature, fat accumulation in abdomen and face, low blood sugar level, late onset of puberty which sometimes may never occur. In adults, the symptoms are associated with reduced muscle mass, low bone density, increased body fat, high LDL cholesterol, fatigue, depression and poor sleep. Diagnosis of GHD with children is often with the examination of their height and weight which do not follow the growth chart. Diagnosis is performed with the blood test that assesses the levels of IGF-1 and IGFBP-3 proteins, levels of growth hormones, other hormone levels in the blood which are produced by the pituitary gland, insulin tolerance test and growth hormone stimulation test. The treatment for GHD for both adults and children are growth hormone therapy which may be administered as injections. Children generally require higher doses of growth hormone than adults.
Acromegaly
Acromegaly is the rare growth disorder resulting from the excess of growth hormone produced by the pituitary gland. It affects only about 3-4 individuals in a million annually. This disorder is also known as gigantism and tends to be diagnosed in adults. The cause of this condition is the benign tumor in about 95% of the cases and 5% of non-pituitary tumors resulting in excess growth hormone secretion. The individuals with this disorder illustrate physical characteristics such large hands, feet, thick lips, wide spaced teeth and protruding face and jaw. The other associated symptoms include sleep apnoea, menstrual disorders, glucose intolerance, heart conditions, vision problems, low sex drive and osteoarthritis. The diagnoses involve measuring the level of IGF-1 (insulin-like growth factor-1) in the blood which is produced by the liver and tissues. The other tests include MRI imaging of the pituitary and hypothalamus for a tumor that may cause the excess hormone production. The treatment may consist of the surgical removal of the tumor from the pituitary gland, medications to reduce the levels of growth hormones and irradiation of the pituitary gland.